Final Exam Homework Questions (19, 20, 21, and 17)

A 68-year-old woman was bitten several times by mosquitoes while gardening and now has a fever, neck stiffness, and a severe headache.

Encephalitis

death from respiratory arrest; caused by Clostridium; potent neurotoxin

both Tetanus and Botulism

An intoxication, associated with eating poorly preserved foods, which results in flaccid paralysis

Botulism

blocks release of acetylcholine; bioterrorism agent; food intoxication

Botulism

Slow, progressive zoonotic viral disease characterized by fatal encephalitis and with hydrophobia as a symptom

Rabies

bat; treatment is post exposure passive and active immunization

Rabies

Caused by a number of bacteria and results in nasal congestion, pressure above the nose or in the forehead, and headache

Sinusitis

Influenza is caused by one of three types of virus; A, B, or C, and the ___________ of each is segmented, comprising seven or eight strands of _______ . Certain types of virus can infect both humans and ________ , whereas others infect both swine and birds. All of them contain genes for the virulence factors hemagglutinin (H) and neuraminidase (N), albeit in a difference sequence. _________________ binds to the host cell receptors allowing entry into the cell, and ________________ breaks down mucus and contributes to budding and release from the host. If a virus is transmitted from a human to a _______ at the same time that another virus is transmitted from a bird to a _______ , these two different types of virus can infect the same ___________ cell. This increases the likelihood that an error in _______________ will result in a virus with seven strands of RNA from the human-originated virus and a single strand from the virus that was transmitted from the bird. If the new virus is able to infect a human, proteins coded for by the bird virus RNA will not be recognized by the human ___________ ______________ , regardless of whether or not the individual received a flu vaccine. In the event of a pandemic arising from this type of genetic shuffling, an additional vaccine will have to be created, since the annual flu vaccine accounts only for genetic __________ , not genetic _________.

1) genome 2) RNA 3) swine 4) Hemagglutinin 5) neuraminidase 6) pig 7) pig 8) swine 9) packaging 10) immune system 11) drift 12) shift

A healthy six-month-old infant was visiting her grandparents in late 2010. 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. The following are the answers the parents provided for the patient history questionnaire: 1. Question: What have been the patient's symptoms? Answer: A dry cough and runny nose early on, followed by the development of a violent cough with extreme fatigue. 2. Question: When did the patient being to exhibit symptoms? Answer: 10 days ago, with the most severe symptoms starting 3 days ago. 3. Question: Has the patient traveled recently? Answer: Patient just returned from a trip to see relatives in Southern California. 4. Question: Has anyone else in the family traveled recently? Answer: Patient's father just returned from a business trip to Australia. 5. Question: Has the patient experienced any other recent illness? Answer: No. 6. Question: Has anyone else in the family recently experienced any illness? Answer: Patient's father has just recovered from a slight cold three weeks ago. 7. Question: Is the patient up to date with vaccinations for her age (6 months)? Answer: Patient is supposed to receive vaccinations in two days at her 6-month check up appointment. 1. Based upon all of the information obtained through specimen testing, along with the patient's symptoms, the pathogen is most likely: A. Mycobacterium tuberculosis B. Influenza A C. Streptococcus pyogenes D. Bordetella pertussis 2. Based upon this identification, what was the most likely mode of transmission of this pathogen? A. Fomite B. Blood-borne C. Droplet contact D. Vector-borne 3. Based upon this diagnosis, what disease is the patient suffering from? A. Whooping cough B. Tuberculosis C. Strep throat D. Flu 4. Based upon the patient history information, the patient appears to be in which stage of disease? A. Convalescent B. Paroxysmal C. Catarrhal 5. Which form of treatment should be administered to the patient at this time? A. Rifampin B. Azithromycin C. Supportive care as needed D. Amphotericin B 6. A 35-year-old man who will become a father in the next 6 months visits your clinic. Which vaccine would you recommend to him? A. DTaP B. Tdap C. Td 7. Which hypothesis could explain the recent outbreaks of pertussis in various areas of the United States? A. Antigenic variation of the pathogen B. Failure of individuals to receive vaccination in adulthood C. Noncompliance with vaccine schedule D. All of the choices are correct. 8. True or False: A patient must present the "whooping" sound during coughing to be positively diagnosed with pertussis. 9. True or False: The infant patient in the case should have been adequately protected from infection with Bordetella pertussis from the vaccinations she had already received.

1. Bordetella pertussis 2. Droplet contact 3. Whooping cough 4. Paroxysmal 5. Azithromycin 6. Tdap 7. all of the choices are correct 8. false 9. false

In 1998, a journalist returned to the United States from Azerbaijan after reporting on the country's political stability after the breakup of the former Soviet Union. Three days after she returned home, she developed a low-grade fever, a sore throat, and a general feeling of malaise. She assumed she had been infected with a virus on the flight home. Within days, her symptoms escalated, and she had difficulty swallowing. Her physician noticed a gray membrane at the back of her throat and decided to take a swab sample from her throat. He observed the club-like organisms shown here. 1. What disease is the journalist likely to have and why was she not immune? A. Whooping cough—she had not had the disease before. B. Strep throat—most encounters with S. pyogenes cause the disease. C. Diphtheria—she was not vaccinated as a child. D. RSV—adults are particularly susceptible. Influenza—she did not get her annual flu vaccine. 2. If the journalist was susceptible to this disease, why did she not develop it in the United States? A. Corynebacterium diphtheriae has been eradicated. B. She was protected by herd immunity; those around her received the vaccination in childhood. C. The organism is transmitted via the oral-fecal route; therefore, good sanitation in the United States prevents infection. D. She may have developed the disease without realizing it; it is often asymptomatic.

1. C. Diphtheria—she was not vaccinated as a child. 2. B. She was protected by herd immunity; those around her received the vaccination in childhood.

One of the most disturbing and gut-wrenching cases I was ever involved in concerned a 10-year-old girl who was brought to the emergency room by her mother, who was afraid her daughter had appendicitis. What her daughter turned out to have was far more troubling. The patient had developed a high fever (39.4 degrees Celcius [103 degrees Fahrenheit]) and was complaining of severe lower abdominal pain. Upon questioning, the patient also admitted to painful urination. As I led her into an examining room, I 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 in my mind. After performing a quick abdominal examination and obtaining vital signs, I found the physician on call and told her about the patient's symptoms. I also described how the patient moved with an odd shuffling gait. Although I could not recall what I had learned about the symptom, I know that it was a diagnostic feature. The physician asked me how old the patient was and asked if I had had the opportunity to ask the patient whether she was sexually active. I had not done so due to the patient's age. To my surprise, the physician asked me to prepare for an internal (vaginal) exam in another room while she examined the patient and spoke to her mother. The young patient featured in this case was given a pelvic exam after consent was obtained from the patient's mother. The patient 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 describe 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. The patient was only 10 years of age, which should raise suspicion of child abuse. Not only should the case be reported to the appropriate state health authority, but it should also be reported to social services or the police in order to determine whether the patient was a victim of abuse. 1. Which of the following structures is involved in the increased pathogenicity of N. gonorrhoeae? A. Fimbriae B. Endospores C. Capsule D. Cell wall 2. True or False: The roughly 350,000 cases of gonorrhea reported in the United States each year is an accurate representation of disease incidence in this country. 3. Which of the following drugs is commonly used for the treatment of gonorrhea today? A. Acyclovir B. Clindamycin C. Azithromycin D. There is no common treatment due to the development of resistance.

1. Fimbriae 2. False 3. There is no common treatment due to the development of resistance.

A 31-year-old woman is 8 months pregnant with her first child. Her general health is completely normal, as is the health of her developing fetus. She works in an office as a data entry clerk. One day she develops a fever, nausea, and muscle aches. She decides to leave work early and rest at home. Her symptoms persist for 2 days but do not develop any further. Three weeks later, she realizes that the fetus is not as active as it had been in the days' prior. After 24 hours of virtually no movement, she calls her physician. In a whirlwind of panic, she undergoes a sonogram and is told a fetal heartbeat can no longer be detected. The following are the answers the patient provided for the patient history questionnaire: 1. Have you consumed water from an unprotected source in the past 2 months? Response: No, I have only drank bottled water since I became pregnant. 2. Have you been bitten by any animals or insects in the past 2 months? Response: Yes, mosquitoes. 3. Have you traveled outside of the country in the past 2 months? Response: Yes, to Mexico (Cancun). 4. Have you eaten at any restaurants in the past 2 months? Response: Yes, at a local deli. 5. Have you consumed any unpasteurized or any improperly cooked or stored food in the past 2 months? Response: Not that I am aware of. 6. Have you consumed any deli meats or prepared foods from vending machines in the past 2 months? Response: Yes, I ate sandwiches made with deli-style turkey meat almost every week during my pregnancy. Due to the fact that the patient and fetal cultures did not grow well, even on blood agar, rapid testing was performed on the specimens to confirm the patient's diagnosis. The ELISA and indirect staining were negative for any viral, fungal, or protozoan pathogens but were positive for a gram-positive bacterium that would produce the same phenotypic results as seen in the culturing of the patient specimen. 1. Based upon all of the information obtained through specimen testing, along with the patient's symptoms, the pathogen is most likely _______. A. Escherichia coli B. Listeria monocytogenes C. Streptococcus agalactiae D. Haemophilus influenzae 2. Based upon this identification, what was the most likely mode of transmission of this pathogen in the patient? A. Parenteral route B. Sexual activity C. Respiratory route D. Vehicle transmission 3. Based upon this information, what is the patient's diagnosis, and what infection ended the life of the fetus? A. Listeriosis; listeriosis B. Gastroenteritis; listeriosis C. Gastroenteritis; group B strep colonization D. Listeriosis; neonatal meningitis

1. Listeria monocytogenes 2. Vehicle transmission 3. Listeriosis; neonatal meningitis

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. 1. What organ is primarily affected by hepatitis B infection? A. Kidneys B. Liver C. Heart D. Brain 2. Which of the following patients would be most at risk for acquiring hepatitis B virus? A. 36-year-old female using multiple IV drugs B. 28-year-old man living in a homeless shelter C. 45-year-old female engaging in unprotected sex D. 65-year-old healthcare worker at the homeless clinic 3. The RN educates her patient population that the primary method of prevention for hepatitis B infection is _______. A. barrier protection during sex B. avoidance of IV drugs C. handwashing D. vaccination 4. Initial serological testing for a patient with recent exposure to hepatitis B may detect which of the following? A. Virus antigen B. Virus antibody C. Viral load D. Virus antigen and virus antibody 5. The RN provides education for patients regarding the potential complications caused by the hepatitis B virus. Which of the following are life-threatening complications of hepatitis B infection? A. Liver cancer B. Chronic liver disease C. Glomerulonephritis D. All of these choices are correct.

1. Liver 2. 36-year-old female using multiple IV drugs 3. vaccination 4. Virus antigen 5. All of these choices are correct.

A RN at a high school is teaching a health education course about sexually transmitted infections. She provides the students with information about gonorrhea. 1. Which of the following are possible symptoms of gonorrhea in males? A. Painful urination and yellowish discharge or no symptoms B. No symptoms C. Painful urination and yellowish discharge D. Flank pain and pink-tinged urine 2. Which of the following are possible symptoms of gonorrhea in females? A. No symptoms B. Painful urination and bloody vaginal discharge C. Painful urination and mucopurulent vaginal discharge D. All of these choices are correct. 3. All of the following are potential complications of gonorrhea, except ________. A. ectopic pregnancy B. pelvic inflammatory disease C. spontaneous abortion D. infertility 4. Which of the following statements by a student demonstrates a proper understanding of gonorrhea transmission? A. If I am infected with gonorrhea and have no symptoms, I can still pass the disease to others B. If my partner has no symptoms, I cannot contract gonorrhea C. If I have no symptoms, I cannot transmit gonorrhea to others D. I may acquire the disease through casual contact with an infected person 5. Which of the following is an effective form of gonorrhea prevention? A. Use of condoms B. Abstinence C. Use of condoms and abstinence D. Vaccination

1. Painful urination and yellowish discharge or no symptoms 2. All of these choices are correct. 3. spontaneous abortion 4. If I am infected with gonorrhea and have no symptoms, I can still pass the disease to others 5. Use of condoms and abstinence

A 21-year-old college student presents to the university campus clinic. The nurse collects the patient's medical history and performs an initial assessment. The patient states, "I'm having a herpes flair, and I need a prescription for acyclovir." The nurse examines the lesion on the shaft of his penis. The ulcer is 2 cm in size and seems painless and hard upon palpation. 1. Based upon the assessment of the lesion, what is the most likely diagnosis? A. Primary syphilis B. Herpes C. Human papillomavirus infection D. Chancroid 2. The student states, "My friend had syphilis, but the lesion healed without antibiotics. Do I really need to take medications?" What is the best response by the nurse? A. The lesion will probably heal independently, but antibiotics will make it heal faster. B. Syphilis is primarily viral in nature so an antibiotic is used to prevent bacterial infection of the healing lesion. C. Antibiotics will protect you from contracting other sexually transmitted infections while the lesion is healing. D. The lesion will heal on its own, but latent syphilis will cause serious disease later on and must be treated.

1. Primary syphilis 2. The lesion will heal on its own, but latent syphilis will cause serious disease later on and must be treated.

A telephone advice RN receives a phone call from a 75-year-old male who sustained a raccoon bite two hours ago. The patient reports pain at the site of injury but no other symptoms. 1. Which of the following diseases is the greatest risk to the patient, considering the mechanism of injury? A. Tetanus B. Meningitis C. Botulism D. Rabies 2. The RN advises the patient to seek medical attention ______. A. immediately B. in the next 7 days C. in the next 24 hours D. if systemic symptoms begin 3. If the patient is diagnosed with this infectious disease, the RN anticipates that treatment of the patient will include which of the following? A. Wound care with immune globulin B. Intramuscular injection of immune globulin C. Human diploid cell vaccine course D. All of these would be treatments. 4. The RN advises the patient that without treatment, he is at risk of which of the following? A. Neurological impairment B. Paralysis C. Temporary encephalitis D. Fatal encephalitis

1. Rabies 2. immediately 3. All of these would be treatments. 4. Fatal encephalitis

A 3-year-old boy presents to the emergency department. His parents report three 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 for rehydration and gastrointestinal illness work up. 1. The patient's symptoms are most concerning for which of the following infectious organisms as the cause of acute diarrhea? A. Shiga-toxin-producing Escherichia coli B. Clostridium difficile C. Vibrio cholerae D. Campylobacter 2. The RN collects the patient's history from the parents. Which of the following statements would raise concern for the potential that the patient has been infected with shiga-toxin-producing E. coli? A. Infrequent handwashing B. Family history of gastroenteritis C. Swimming in a lake the previous weekend D. Ingestion of undercooked hot dog at county fair 3. The RN expects all of the following to be ordered as treatment for this patient, except ________. A. electrolyte replacement B. plasma transfusions C. fluid resuscitation D. antibiotics 4. Three days later, the patient is started on dialysis. Which of the following is a serious complication of the patient's infection with the potential to cause kidney injury and renal failure? A. Urinary tract infection B. Hemolytic uremic syndrome C. Cirrhosis D. Guillain-Barré syndrome

1. Shiga-toxin-producing Escherichia coli 2. Ingestion of undercooked hot dog at county fair 3. antibiotics 4. Hemolytic uremic syndrome

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. 1. The RN advises the mother to assess the child's oral cavity. The observation of which clinical sign would be most significant in the diagnosis of pharyngitis caused by a streptococcal organism? A. Red oral mucosa B. Foul-smelling breath C. White pockets of exudate D. Swollen tonsils 2. 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: A. Scarlet fever B. Glomerulonephritis C. Hemolytic uremic syndrome D. Rheumatic fever 3. The RN advises the mother to observe for symptoms in the other children in the household. When can she expect to see symptoms emerge if the other children become infected? A. 2-5 days B. 24-48 hours C. 5-7 days D. 12-24 hours 4. To confirm the diagnosis and begin appropriate treatment, the RN expects all of the following to be ordered except ________. A. rapid pharyngeal swab test B. bed rest C. pharyngeal culture D. penicillin 5. The patient's rapid strep A test comes back positive in 1 hour. How would the RN best communicate to the mother that the medical team may be wary of confirming the diagnosis of strep throat based upon this information alone? A. The rapid strep test requires 24 hours to be conclusively diagnostic. B. The rapid strep test has a high risk of contamination. C. The rapid strep test requires 12 hours to be conclusively diagnostic. D. The rapid strep test has a high risk of false-negative results.

1. White pockets of exudate 2. Hemolytic uremic syndrome 3. 2-5 days 4. bed rest 5. The rapid strep test has a high risk of false-negative results.

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 and made arrangements to follow up with the patient to ensure that he was complying with treatment. 1. Mycobacterium tuberculosis is a(n) ______. A. virus B. fungus C. bacterium D. protozoan 2. In this case study, all new employees at the hospital were required to have which test to rule out tuberculosis? A. Mantoux skin test B. Complete Blood Count (CBC) test C. Rapid HIV test D. Chest X ray 3. The degree of scarring in the lungs as seen on the chest X ray film surprised the clinicians due to the patient's ______. A. gender B. line of work C. ethnicity D. young age 4. True or False: The diagnosis of tuberculosis was confirmed by the clinical findings consistent with this disease in the patient's chest X ray.

1. bacterium 2. Mantoux skin test 3. young age 4. false

A hospital is experiencing an outbreak of rotavirus. An RN on a pediatric surgical unit takes precautions to protect her patients from acquiring the disease. 1. When assisting with care activities for a patient with rotavirus, the RN should observe all of the following standard precautions, except ________. A. handwashing B. donning a mask C. donning gloves D. donning a gown 2. The occurrence of which of the following symptoms in an 18-month-old patient would cause concern for infection with rotavirus? A. Watery diarrhea B. Vomiting C. Fever D. All of these choices are correct. 3. 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? A. Adults may develop serious symptoms from rotavirus infection. B. If you have been washing your hands regularly, you are not at risk for acquiring rotavirus infection. C. You should be screened for rotavirus infection to prevent further transmission of the virus. D. Adults may acquire rotavirus infection, but symptoms are generally mild. 4. What treatment would the RN anticipate to be ordered for an infected 18-month-old patient? A. Antibiotics B. Antivirals C. Vaccination D. Fluid and electrolyte replacement

1. donning a mask 2. All of these choices are correct. 3. Adults may acquire rotavirus infection, but symptoms are generally mild. 4. Fluid and electrolyte replacement

I was a respiratory therapist student completing a rotation in pediatrics when I became involved in caring for Michael, a 6-month-old who was admitted to the pediatric unit with a respiratory infection. Michael was a healthy infant who was born at term (39 weeks' gestation). He was current with all of his immunizations. Michael was the youngest of three children, with two older siblings who were school age. Michael attended day care on a part-time basis when his mother worked. Michael and both his siblings had become ill during recent days with cold symptoms. At first, Michael had a runny nose and a slight cough. He was fussy and irritable and his mother stated he had been sleeping more than usual. Michael was being breast-fed. However, when he became ill, he fussed at the breast and fed less often, even though his mother offered him the breast frequently to encourage fluid intake and provide comfort. Having three children, Michael's mother was well versed in caring for a sick child and was not prone to panic over a common cold. However, on the third day of his illness, Michael took an alarming turn for the worse. Although he acted as though he was hungry, he would stop feeding almost as soon as he started. Michael had copious nasal discharge, and his mother rightly tried to clear his nostrils using a bulb syringe, but Michael still fed poorly. He had only had one slightly wet diaper over the course of the night and had not urinated at all in the morning. He was running a high fever of 39.6°C (103.3°F). His eyes appeared sunken in his face and there were no tears when he cried, both signs of dehydration. He was coughing frequently. Most concerning, Michael's respiratory rate was 48 breaths/minute. His nail beds were cyanosed (blue) and he was very pale in color. His oxygen saturation was 89% on room air. Michael was seen in the emergency room and was immediately admitted to the pediatric unit by the physician on call, who was very concerned. My preceptor and I were called to assess Michael on the unit. When we arrived, Michael had a chest X ray and blood work done. He was lying in a crib with a nasal cannula supplying humidified oxygen taped to his face. His color was still very pale but his nail beds were pink. His oxygen saturation had increased to 95% with oxygen flow at 5 L/minute. I listened to Michael's chest and heard wheezes throughout Michael's lungs. After I assessed Michael, my preceptor asked me what I thought might be going on with Michael. Hedging my bets, I replied that all I could tell for certain was that Michael had a respiratory tract illness and a virus was the likely culprit. My preceptor promptly replied, "You're right that Michael has a viral illness of the respiratory tract, but which one?" When I confessed that I did not know, my preceptor informed me that Michael's symptoms were consistent with respiratory syncytial virus (RSV). Michael's tests would prove him right. 1. RSV is a _______. A. bacterium B. protozoan C. fungus D. virus 2. RSV is an infection of the _______ respiratory tract. A. upper and lower B. upper C. lower 3. What age group is the most susceptible to serious RSV infection? A. Elderly persons B. College students C. Preschool children D. Children under 6 months 4. What other disease(s) affect both upper and lower respiratory tracts? A. Tuberculosis B. Pertussis C. Tuberculosis and Influenza D. Tuberculosis and Pertussis E. Influenza and Pertussis 5. How is pertussis different from RSV infection? A. Pertussis affects the upper and lower respiratory tracts. B. Pertussis is treated with antivirals. C. Pertussis is caused by a bacterium. D. Pertussis is spread by droplet contact. 6. In this case, Michael likely contracted RSV from his ________. A. day care or siblings B. mother's breast milk C. mother during birth D. pet 7. RSV infection is prevented with ________ immunity in high-risk groups like premature infants. A. natural, passive B. artificial, active C. natural, active D. artificial, passive

1. virus 2. upper and lower 3. Children under 6 months 4. Influenza and Pertussis 5. Pertussis is caused by a bacterium. 6. day care or siblings 7. artificial, passive

Caused by hundreds of viruses and results in sneezing, scratchy throat, and runny nose

Common cold

caused by a prion; contaminated meat

Creutzfeldt-Jakob Disease

The endospore-forming bacterium, _________, contaminates meat and vegetables, and in other situations causes gas gangrene. A. Staphylococcus aureus B. Clostridium perfringens C. Bacillus cereus D. Shigella

B. Clostridium perfringens

The most common bacterial cause of diarrhea in the United States is ________. A. Campylobacter B. Salmonella C. Yersinia D. Shigella E. E. coli

A. Campylobacter

Which of these microorganisms is associated with Guillain-Barre syndrome? A. Campylobacter B. E. coli C. Salmonella D. Shigella

A. Campylobacter

A nurse in the emergency department is caring for a 23-year-old female who is on vacation for her honeymoon. Two days ago, she began experiencing burning while voiding and a tactile fever. The patient reports she has been treating the symptoms with cranberry tablets and increased fluid intake. Her symptoms have not improved and now she is experiencing a frequent urge to void and lower abdominal pain. Upon assessment, the nurse finds the patient has a low-grade fever. Based on the patient's clinical presentation, which of the following diagnoses is most likely? A. Cystitis B. General urinary tract infection C. Pyelonephritis D. Urethritis

A. Cystitis

The most common causative agent of urinary tract infections is ________. A. Escherichia coli B. Staphylococcus aureus C. Escherichia coli O157:H7 D. Pseudomonas aeruginosa E. Streptococcus pyogenes

A. Escherichia coli

Based on what you know about rhinovirus infection, do you think the data in the left graph is an accurate presentation of the total number of common colds in Colorado during 2016? A. No, the common cold is caused by more than rhinoviruses, and most patients do not get tested in the laboratory for this infection. B. No, the diagnostic methods for rhinovirus infection are unreliable, and this graph likely includes many false positive diagnoses. C. Yes, they are laboratory-confirmed so there is diagnostic accuracy. D. Yes, rhinovirus infection is a notifiable disease, and the CDC monitors the rates across the country closely.

A. No, the common cold is caused by more than rhinoviruses, and most patients do not get tested in the laboratory for this infection.

The predominant causative organism of dental caries seem to be ________. A. Streptococcus mutans B. Staphylococcus aureus C. Streptococcus pyogenes D. Staphylococcus epidermidis E. Streptococcus pneumoniae

A. Streptococcus mutans

Infection of the urinary bladder is called ________. A. cystitis B. urethritis C. PI D. vaginitis E. pyelonephritis

A. cystitis

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. A. shift; drift B. drift; shift C. switch; drift

A. shift; drift

mosquitoes; an example is West Nile infection

Arboviral Encephalitis

What conclusion can you draw from the data presented in these graphs? A. Influenza is more common during the winter whereas rhinovirus is more common during the spring. B. Both respiratory diseases appear to have higher rates during times of the year when the temperatures tend to be colder. C. Allergies most likely affect the rates of rhinovirus, leading to higher incidence in the fall when compared to influenza. D. Rhinovirus has a higher incidence than influenza during all months of the year. E. Nothing can be determined because these are two kinds of graphs.

B. Both respiratory diseases appear to have higher rates during times of the year when the temperatures tend to be colder.

During which stage of syphilis does fever, lymphadenopathy, and a red to brown rash occur? A. Primary B. Secondary C. Tertiary D. Latent E. All of the choices are correct.

B. Secondary

Based on what you know about influenza and the data presented in the right graph, when would be the best time to receive an influenza vaccination? A. February B. September C. October D. April

B. September

Choose the microorganism that is the most common cause of bacterial meningitis in adults to test your understanding of this disease. A. Neisseria meningitidis B. Streptococcus pneumoniae C. Haemophilus influenzae D. Listeria monocytogenes

B. Streptococcus pneumoniae

Which pathogen has evolved to make its rodent host less avoidant of cats? A. Neisseria meningitidis B. Toxoplasma gondii C. Cryptococcus neoformans D. Rabies virus

B. Toxoplasma gondii

Mosquito eradication could change the epidemiology of ______. Check all that apply. Check All That Apply A. polio B. Zika infection C. West Nile encephalitis D. botulism

B. Zika infection C. West Nile encephalitis

Syphilitic lesions called _______ develop in the liver, skin, bone, and cartilage during the tertiary stage of syphilis. A. chancres B. gummas C. ulcers D. nodules E. None of the choices are correct.

B. gummas

Orchitis and epididymitis are seen in young adult males as a complication of ________. A. measles (rubeola) B. mumps C. rubella D. influenza E. croup

B. mumps

The urinary tract defenses in both males and females consists of mechanical factors such as ________, and chemicals like ________, to prevent the growth of pathogens in the system. A. lysis of foreign cells; interferons B. the flushing action of urine; lysozyme C. phagocytosis; interleukins D. the inflammatory response; leukotrienes

B. the flushing action of urine; lysozyme

Streptococcus pyogenes infection that results in a sore throat with reddened mucosa, swollen tonsils, and pus nodules

Bacterial pharyngitis

3 forms based on mode of transmission and affected population; flaccid paralysis

Botulism

A 5-month-old with colic was given her pacifier dipped in honey to ease her crying and is now having difficulty sucking, is 'floppy', and has labored breathing.

Botulism

Which of the following STIs is curable with antimicrobials? A. HPV B. Genital herpes C. Chlamydia

C. Chlamydia

Which of the following organisms is anaerobic? A. Poliovirus B. Coccidioides C. Clostridium D. Cryptococcus

C. Clostridium

Which of the following is not a normal causative agent of food poisoning? A. Clostridium perfringes B. Staphylococcus aureus exotoxin C. Clostridium difficile D. Bacillus cereus E. All of the choices are correct.

C. Clostridium difficile

According to this figure, what nervous system disease would likely result in death to a person that contracts the disease but is not transmitted directly to other people? A. Polio B. Syphilis C. Rabies D. Measles

C. Rabies

Permanent cardiovascular and neurological damage is seen in which stage of syphilis? A. Primary B. Secondary C. Tertiary D. Latent E. All of the choices are correct.

C. Tertiary

The most common reported STD in the United States is ________. A. genital herpes B. HIV C. chlamydia D. gonorrhea E. syphilis

C. chlamydia

Most frequent cause of diarrhea resulting in watery stools, fever, vomiting, headaches, and severe abdominal pain

Campylobacter jejuni

Which disease is caused by an infectious agent that carries no nucleic acid? A. Meningitis B. Polio C. Rabies D. CJD

D. CJD

The normal gut microbiome in adults, but not infants, inhibit the growth of which pathogen? A. Neisseria meningitidis B. Naegleria fowleri C. Clostridium tetani D. Clostridium botulinum

D. Clostridium botulinum

Your patient is a 4-year-old male. His mother reports that two days ago, he developed a runny nose, was very lethargic, and ran a fever. She assumed he was getting a cold or the flu but that morning she was alarmed at the swollen glands in his neck. He attends a community-run preschool, and on taking a history, she tells you that she usually takes him to a naturopathic practitioner. She tells you that he has not had any vaccines because she read that they cause autism. What disease is the child likely to have given the history and manifestations? A. Tapeworm B. Ulcers C. Influenza D. Mumps

D. Mumps

This image depicts an acid-fast stained sputum sample showing red bacilli. What might be a preliminary diagnosis for this patient? A. Diphtheria B. Influenza C. Pertussis D. Tuberculosis

D. Tuberculosis

All of the following pertain to Clostridium difficile infection except it ________. A. is a colitis that is a superinfection B. often has an endogenous source C. is associated with disruption of normal flora due to broad-spectrum antimicrobials D. is due to ingestion of contaminated, improperly stored, cooked meats and gravies E. is the major cause of diarrhea in hospitals

D. is due to ingestion of contaminated, improperly stored, cooked meats and gravies

Caused by Corynebacterium diphtheriae which eventually results in pseudomembrane formation on the tonsils or pharynx

Diphtheria

The causative organism of whooping cough is ________. A. Haemophilus influenzae B. Streptococcus pyogenes C. Streptococcus pneumoniae D. Corynebacterium diphtheriae E. Bordetella pertussis

E. Bordetella pertussis

Which group is at greatest risk for group B Streptococcus infection? A. Pregnant women B. 21-year-old males C. 21-year-old females D. Older adults (age 65 years and older) E. Neonates

E. Neonates

"Rice-water stools" are associated with disease caused by which organism? A. Helicobacter pylori B. Campylobacter jejuni C. Vibrio parahaemolyticus D. Vibrio vulnificus E. Vibrio cholerae

E. Vibrio cholerae

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

Escheria coli O157:H7

True/False: The HPV vaccine prevents infection by all types of human papillomaviruses.

False

True/False: The antivirals used for herpes simplex infections have the ability to completely destroy the virus and permanently cure the latent infection.

False

True/False: The upper and lower respiratory tract, due to constant contact with the external environment, possesses a large amount of normal microbiota.

False

True/False: These two graphs cannot be compared because they are different types of graphs and do not depict the same kind of data.

False

Results from streptococcal proteins forming immune complexes which are deposited on the basement membranes of the kidney

Glomerulonephritis

Viral infection causing chills, body aches, headache, and fever

Influenza

Most common cause is Streptococcus pneumoniae and results in a sensation of fullness or pain in the ear

Otitis media

Caused by Bordetella; called "whooping cough"

Pertussis

Acute enteroviral infection of the spinal cord that can cause neuromuscular paralysis

Poliomyelitis

Streptococcal toxins that act as superantigens and cause skin issues

Psoriasis

Viral infection characterized by giant multinucleated cells

RSV infection

Due to an immunological cross reaction between the streptococcal M protein and heart muscle

Rheumatic fever

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

Salmonella typhi

Results from a Streptococcus pyogenes strain that is infected with a toxin-coding bacteriophage and is characterized by a sandpaper-like rash

Scarlet fever

Diarrhea containing blood and mucus from the GI tract

Shigella dysenteriae

A 73-year-old farmer gashed his hand on a barbed wire fence one week ago and is now experiencing uncontrollable muscle spasms in his jaw.

Tetanus

A neuromuscular disease caused by a spore-forming bacterium that produces a powerful neurotoxin that leads to spastic paralysis

Tetanus

blocks inhibition of muscle contraction; direct transmission (burns, punctures)

Tetanus

spastic paralysis; vaccine-preventable disease caused by endospore-forming rod

Tetanus

A woman gives birth to an infant with severe liver damage and hydrocephalus. She owns several cats.

Toxoplasmosis

True/False. Evidence suggests that people with high numbers of the bacteria associated with periodontitis may also have increased rates of cardiovascular disease.

True

Diarrhea described as rice water stools

Vibrio cholerae

Syphilis spirochete passes through placenta to infect fetus

congenital syphilis

Neurosyphilis can be present as well as gummas

tertiary or latent syphilis

Hard, painless chancre at site of spirochete entry

primary syphilis

A hunter in NC was bitten by a raccoon caught in his trap eight weeks ago, now displays agitation, disorientation and seizures.

rabies

Fever, headache, and sore throat, followed by lymphadenopathy and a peculiar red or brown rash on all skin surfaces, including the palms and the soles

secondary syphilis