Chapter 22

Why would conjugation to a protein carrier improve the efficacy (i.e. improve the immune response generated by the vaccine) of a polysaccharide vaccine? a. In contrast to polysaccharide vaccines, protein-conjugated vaccines elicit a strong T-cell dependent response. b. Polysaccharides are not immunogenic and therefore do not elicit an immune response. c. The protein carrier allows the vaccine conjugate to be transported to more sites involved in generating the immune response therefore the overall response that is generated will be stronger. d. Proteins are much larger molecules than polysaccharides; therefore they stimulate a larger immune response.

a. In contrast to polysaccharide vaccines, protein-conjugated vaccines elicit a strong T-cell dependent response

What is the likely cause for the drop in glucose levels? a. N. meningitidis uses the glucose as a source of energy to fuel its growth. b. Upon infection of the CSF, the body actively transports glucose from the CSF as a mechanism of "starving" the bacteria. c. N. meningitidis produces a virulence factor which breaks down extracellular glucose so that immune cells are unable to use it as a source of energy. d. During infection glucose is preferentially taken up in anatomical locations required for generating the immune response (e.g. bone marrow); therefore glucose drops in other locations such as the CSF.

a. N. meningitidis uses the glucose as a source of energy to fuel its growth.

Which of the following statements concerning the blood-brain barrier is FALSE? a. Penicillin is useless against infections of the brain because it is completely incapable of crossing the barrier. b. Substances that are lipid-soluble can cross the blood-brain barrier readily. c. Most antibiotics cannot cross the blood-brain barrier. d. Inflammation can alter the blood-brain barrier, increasing the likelihood that a substance can cross.

a. Penicillin is useless against infections of the brain because it is completely incapable of crossing the barrier

Which of the following is an accurate statement concerning the Sabin and Salk vaccines? a. The Sabin vaccine is slightly more dangerous because it is made from live, attenuated virus, and the virus occasionally reverts back to its pathogenic form. b. The Salk vaccine is more effective in conferring immunity. c. The Salk vaccine is cheaper to make than the Sabin vaccine. d. The Salk vaccine is easier to administer because it is given orally.

a. The Sabin vaccine is slightly more dangerous because it is made from live, attenuated virus, and occasionally reverts back to its pathogenic form

All of the following are true of chronic fatigue syndrome EXCEPT a. it is a psychological disorder. b. it often begins with flu-like symptoms that do not go away. c. it may be triggered by a viral infection. d. it may have a genetic component. e. it is also known as myalgic encephalomyelitis.

a. it is a psychological disorder

It is time to confirm your diagnosis. Select the best samples to accurately confirm a diagnosis of rabies in your patient. Select all that apply. a. saliva b. neck tissue biopsy c. brain tissue biopsy d. CSF e. blood

a. saliva b. neck tissue biopsy d. CSF

Naegleria fowleri meningoencephalitis is commonly acquired by a. swimming in warm ponds or streams. b. exposure to bird droppings. c. exposure to body fluids of a contaminated individual. d. ingestion of water contaminated with fecal material. e. mosquito bites.

a. swimming in warm ponds or streams

Which population is most likely to develop bacterial meningitis? a. senior citizens b. infants and young children c. healthy carriers d. All of the above.

b. Infants and young children

Which of the following statements about Neisseria meningitisis FALSE? a. A healthy carrier state can exist. b. It is a gram-positive anaerobe. c. It is encapsulated. d. Its most distinguishing feature is a unique rash. e. It is typically transmitted by droplet aerosols or direct contact with secretions.

b. It is a gram-positive anaerobe

Which of the following statements about Neisseria meningitisis FALSE? a. A healthy carrier state can exist. b. It is a gram-positive anaerobe. c. It is encapsulated. d. Its most distinguishing feature is a unique rash. e. It is typically transmitted by droplet aerosols or direct contact with secretions.

b. It is a gram-positive anaerobe

Which of the following microbes has NOT been associated with bacterial meningitis? a. Streptococcus pneumoniae b. Mycobacterium leprae c. Haemophilus influenzae d. Neisseria meningitidis

b. Mycobacterium leprae

On October 5, a pet store sold a kitten that subsequently died. On October 22, rabies was diagnosed in the kitten. Between September 19 and October 23, the pet store had sold 34 kittens. Approximately 1000 people responded to health care providers following local media alerts. These people were given a. antibiotics. b. postexposure prophylaxis. c. human diploid cell vaccine. d. antiviral medications. e. immune globulin injections.

b. Postexposure prophyaxis

Which of the following is NOT characteristic of chronic fatigue syndrome (CFS)? a. Sore throat and tender lymph nodes are present. b. Relief can be obtained through exercise. c. Muscle pain is present. d. Sleep is unrefreshing.

b. Relief can be obtained through exercise

Postexposure treatment for rabies includes vaccination and injection of immunoglobulin; these are generally successful if treatment is obtained immediately following exposure. Why does post-exposure vaccination work? a. The virus is highly exposed to the immune system once it enters the peripheral nerves. b. The infection progresses so slowly that there is time for post-exposure vaccination to generate immunity. c. The immune response to this vaccine is very rapid. d. The rabies exposure increases the speed of the adaptive immune response.

b. The infection progresses so slowly that there is time for post-exposure vaccination to generate immunity.

Which statement regarding arboviral encephalitis is FALSE? a. Most human cases of West Nile virus (WNV) are subclinical or very mild. b. The most effective preventive measure for arboviral infections is vaccination. c. Horses, as well as humans, are frequently affected by arboviruses. d. The incidence of disease increases during summer months.

b. The most effective preventative measure for arboviral infections is vaccination

Why should children younger than 1 year of age NOT be fed honey? a. They may contract listeriosis. b. They may contract botulism. c. They may contract tetanus. d. Mycobacterium leprae is present in honey.

b. They may contract listeriosis

Which of the following statements about meningitis is TRUE? a. A vaccine exists to protect people against only meningitis caused by H. influenzae. b. Viral meningitis, while less severe than bacterial meningitis, is more common in occurrence. c. Meningitis is an infection of the cerebral tissue resulting when bacteria or viruses cross the blood brain barrier. d. There are more than 50 bacterial species commonly associated with meningitis.

b. Viral meningitis, while less severe than bacterial meningitis, is more common in occurrence.

All of the following are true regarding African trypanosomiasis EXCEPT a. it is also known as "sleeping sickness." b. all subspecies of Trypanosoma brucei have multiple hosts. c. it is transmitted by the tsetse fly. d. Trypanosoma brucei gambiense is the more common cause of disease. e. death ultimately occurs without proper treatment.

b. all subspecies of Trypanosoma brucei have multiple hosts

All of the following are acquired by ingestion EXCEPT a. poliomyelitis. b. cryptococcosis. c. botulism. d. Creutzfeldt-Jakob disease. e. listeriosis.

b. cryptococcosis

On June 30, a 47-year-old man was hospitalized with dizziness, blurred vision, slurred speech, difficulty swallowing, difficulty breathing, and nausea. Examination revealed facial paralysis and respiratory distress. The patient had partially healed superficial knee wounds incurred while laying cement. He reported eating home-canned green beans and stew containing roast beef and potatoes 24 hours before onset of symptoms. The patient should be treated with: a. surgery. b. supportive care, including respiratory assistance. c. antibiotics. d. vaccination. e. antitoxin.

b. supportive care, including respirator assistance

To help you better understand your patient's condition, you would like to collect some samples for analysis. You decide to take a blood sample, but you would like to take one other type of sample as well. Select the sample that will be most informative if you suspect that your patient has a disease of the central nervous system. a. A muscle tissue sample b. A neural tissue sample c. A CSF sample d. A urine sample e. A fecal sample

c. A CSF sample

A one-year-old boy was listless, irritable, and sleepy. Capsulated Gram-negative rods were cultured from his cerebrospinal fluid. His symptoms were caused by a. a prion. b. rabies. c. Haemophilus influenzae. d. Clostridium tetani. e. Neisseria meningitidis.

c. Haemophilus influenzae

Why is bacterial meningitis considered more life threatening than viral meningitis? a. Viral meningitis is easier to diagnose than bacterial meningitis; therefore treatment can begin earlier in infection. b. It is rare that viral particles are able to cross the blood brain barrier. c. The immune response generated against bacteria leads to a massive influx of immune cells in the meninges; this response is much less extreme in viral meningitis. d. N. meningitidis produces an exotoxin that specifically kills immune cells resulting in a decreased ability to fight the infection.

c. The immune response generated against bacteria leads to a massive influx of immune cells in the meninges; this response is much less extreme in viral meningitis.

All of the following are associated with botulism outbreaks EXCEPT a. type E toxin is associated with seafood. b. endospores of C. botulinum have been recovered from honey. c. type B toxin is most virulent. d. Alaskan natives have the highest rate of botulism. e. antibodies are not an effective method of treatment.

c. Type B toxin is most virulent

If a person in the United States is exposed to rabies, which animal is the most likely culprit? a. domestic cats b. domestic dogs c. wild bats d. wild raccoon

c. wild bats

Which of the following would be an effective treatment for bacterial meningitis? a. PCV b. Hib vaccine c. MCV4 d. Cephalosporins e. All of the above are correct

d. Cephalosporins

Which of the following is an accurate description of Cryptococcus neoformans? a. It is a bacterium that is found in the soil. It causes meningitis and is especially dangerous to pregnant women. b. It is a mycobacterium; infection with this organism can cause disfiguring nodules all over the body. c. It is an ameba that inhabits freshwater and can cause rapidly fatal meningitis. d. It is a fungus found in dried pigeon droppings. When inhaled, it is especially dangerous to immunocompromised individuals and can cause fatal meningitis.

d. It is a fungus found in dried pigeon droppings. When inhaled, it is especially dangerous to immunocompromised individuals and can cause fatal meningitis

All of the following organisms are transmitted via the respiratory route EXCEPT a. Neisseria meningitidis. b. Haemophilus influenzae. c. Cryptococcus neoformans. d. Listeria monocytogenes. e. None of the answers is correce; all of these organisms are transmitted by the respiratory route.

d. Listeria monocytogenes

Which of the following is a free-living amoeba that can cause encephalitis? a. Acanthamoeba b. Naegleria c. Entamoeba d. Naegleria and Acanthamoeba e. Entamoeba and Naegleria

d. Naegleria and Acanthamoeba

Which of the following characteristics are shared by the causative agents of bacterial meningitis? a. They are all prevented through the Hib vaccine. b. They are all diplococci. c. They're all Gram-negative. d. None of the above is correct.

d. None of the above is correct

Which of the following statements regarding African trypanosomiasis is true? a. African trypanosomiasis is a good candidate for vaccine development because T. brucei does not change much during the course of an infection. b. There is no successful treatment for infection with either subspecies of T. brucei. c. The protozoan that causes this infection, Trypanosoma brucei, is transmitted by mosquitoes. d. T.b. rhodesiense not only causes disease, but also severely affects food production because it infects domestic animals, which could otherwise be used for agriculture.

d. T.b. rhodesiense not only causes disease, but also severely affects food production because it infects domestic animals, which could otherwise be used for agriculture

All of the following are true of poliomyelitis EXCEPT a. the majority of cases are asymptomatic. b. initial sites of viral replication are the throat and small intestine. c. infection is due to ingestion of contaminated water. d. the oral polio vaccine contains attenuated strains of the virus. e. most cases result in muscle paralysis.

e. Most cases result in muscle paralysis

Which of the following statements about leprosy is FALSE? a. Diagnosis is based on skin biopsy. b. It is transmitted by direct contact. c. The etiologic agent is acid-fast. d. It is rarely fatal. e. Patients with leprosy must be isolated.

e. Patients with leprosy must be isolated

Initial treatment for tetanus in a fully immunized person with a puncture wound is a. tetanus immune globulin. b. penicillin. c. debridement. d. DTaP. e. tetanus toxoid.

e. Tetanus toxoid

Arboviruses cause ________ and are transmitted by ________. a. meningitis; mosquitoes b. encephalitis; exposure to certain trees c. both meningitis and encephalitis; mosquitoes d. meningitis; exposure to certain trees e. encephalitis; mosquitoes

e. encephalitis; mosquitoes

The prodromal symptom(s) of bacterial meningitis is/are a. mild cold symptoms. b. fever and headache. c. stiff neck and back pains. d. convulsions. e. fever, headache, and stiff neck.

e. fever, headache, and stiff neck

Bacterial encephalitis and meningitis are difficult to treat because a. the infections move along peripheral nerves. b. it is very difficult to determine the causative microbe. c. antibiotics damage nervous tissue. d. no medications exist for treatment of these infections. e. many antibiotics cannot penetrate the bloodbrain barrier.

e. many antibiotics cannot penetrate the bloodbrain barrier

All of the following organisms are correctly matched to the recommended treatment EXCEPT a. Cryptococcus neoformans amphotericin B. b. Neisseria meningitidis cephalosporins. c. Mycobacterium leprae dapsone. d. Haemophilus influenzae cephalosporins. e. poliovirus amphotericin B.

e. poliovirus amphotericin B