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