Unit 5 (Ch. 18, 19, 20, 21)

Your adolescent patient presents to the emergency room with "lock jaw" and is unable to open his mouth to speak. This spastic paralysis is due to which of the following?

Tetanospasmin blocks the release of inhibitory neurotransmitters that prevent muscle relaxation.

Which of the following statements best describes the function of the ureters?

To transmit urine from the kidneys to the bladder

The Center for Disease Control and Prevention recommended that men infected with Zika virus delay planned pregnancies. What is the recommended length of time for delayed conception for men afflicted with Zika virus?

6 months following symptomatic recovery

Which of the following is a possible mode of transmission of tularemia? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

A girl is bitten by an infected tick while hiking in the woods. A hunter cuts his ungloved hand while skinning an infected rabbit.

Which of the following is the most likely mechanism through which bacterial endocarditis is transmitted?

A patient with an artificial heart valve has her gum nicked during a routine teeth cleaning.

Which of the following scenarios would most likely result in Listeria meningitis?

A pregnant woman consumes a sandwich with tainted deli meat and feta (a soft cheese).

Which of the following statements best describes how to perform a pap smear?

A sterile swab is used to collect cervical cells, which are then observed using microscopy.

Your patient presents with a stiff neck, a high fever, nausea, and a headache, indicative of meningitis. A few days prior, the patient experienced fever accompanied by headaches, vomiting, and jaundice. Which of the following is the most likely mechanism through which the patient acquired the infection?

Accidently ingesting water containing rodent urine

Which of the following virulence factors are used by Shigella to facilitate development of disease? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Actin propulsion system Induction of endocytosis Toxin production

Which of the following statements concerning Vibrio cholerae is/are true? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Diagnosis of cholera is performed by culturing Vibrio cholerae from patient stool samples .A key symptom of cholera infection is "rice water" stool.

Your patient, who is in an extended hospital stay, presents with fever, chills, hypotension, tachycardia, and mental confusion. Bloodwork reveals thrombocytosis, elevated creatinine levels, and elevated lactic acid levels, indicative of sepsis. Blood culture on a Sabouraud dextrose agar plate reveals an abundance of yeast. Which of the following is the most likely mechanism through which the patient contracted this disease?

Direct contact with a contaminated venous catheter

Which of the following clinical signs and symptoms is characteristic of a mumps infection? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Dry mouth Swelling of the parotid salivary glands

Which of the following statements concerning the blood-brain barrier is/are correct? To be marked correct, you'll need to select all true statements, as there may be more than one correct answer.

Due to the blood-brain barrier defense mechanisms, infections of the nervous system are often the result of immune system malfunction or an injury to the system. Large essential molecules such as glucose can cross the blood-brain barrier using specialized transporters. Blood vessels are sealed much more tightly in the area around the central nervous system than in other areas of the body.

Your teenage patient presents with muscle weakness and is unable to move her legs. She notes that yesterday she felt a tingling sensation in her feet. Three weeks prior, the patient had a severe diarrheal illness. Which of the following is the most likely mechanism through which the patient contracted this illness?

Eating undercooked chicken

Which of the following may help in controlling outbreaks of Lassa virus?

Effective rodent control and storing food in rodent-proof containers

Which of the following signs and symptoms of infection is/are observed in a patient suffering from mononucleosis? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Enlarged lymph nodes in the neck and armpits Splenomegaly Extreme fatigue

Which of the following symptoms of infection would signify an upper urinary tract infection as opposed to a lower urinary tract infection?

Fever

A menopausal patient is prescribed hormone replacement therapy to boost estrogen levels. Soon after beginning therapy, the patient experiences vaginal itching, burning, and a "cottage cheese-like" discharge. Which of the following would you most readily observe in the patient's pap smear?

Filamentous hyphae

A 1-year old patient presents to the emergency room with fever, headaches, lethargy, stiff neck, and disorientation, with the absence of petechial rash. The mother noted that while her daughter was playing and eating normally that morning, later in the day she developed a non-specific fever and progressed quickly into her current state. When you ask the mother about her daughter's vaccination status, she states that she chose not to vaccinate her daughter due to her personal and religious preferences. Gram-stain analysis of the patient's cerebrospinal fluid reveals Gram-negative, encapsulated cells. Which of the following disease diagnoses is most likely?

Haemophilus meningitis

Your patient complains of upper abdominal pain, heartburn, and indigestion. Based on the patient's case history and clinical presentation, you believe that your patient has a stomach ulcer caused by a resident microorganism. You ask the microbiology laboratory to culture the stomach pathogen from a gastric tissue biopsy. Which of the following bacterial genera would you expect the microbiology laboratory to observe in the patient's culture?

Helicobacter

Your patient presents with oral lesions. The patient states that her mouth had a tingly sensation for 3 days before fluid-filled blisters appeared on the lips. Which of the following pathogens is the most likely etiological agent?

Herpes simplex-1 virus

Which of the following provides the best definition for the term lymph?

Lymph is the plasma that enters and collects in the spaces around the cells in our tissues.

Which of the following strategies is/are used to reduce the incidence of malaria? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Malaria prophylaxis when traveling to endemic areas. Insecticide-treated bed nets. Draining swamps and reducing standing water.

What would be the most appropriate prevention method for meningococcal meningitis for a healthy adolescent, aged 12 years old?

Meningococcal conjugate vaccines (Mentactra®, MenHibrix®, and Menveo®)

Which of the following best describes the role of mucosa-associated lymphoid tissue (MALT)?

Phagocytic protection from pathogens and mediation of immune responses

You are tending to your preschool-aged patient who presents with excessive anal itching. The child's mother notes that the child woke several times during the night due to anal irritation. Gastrointestinal symptoms are absent. You recommend performing a tape test on the child. Which of the following diseases is the pediatric patient most likely afflicted with?

Pinworm

Which of the following accurately states how the lymphatic system and cardiovascular system are connected?

Plasma diffuses from capillaries into the interstitial tissue space, whereas lymphatic vessels funnel lymph toward venous blood supply.

Which of the following are virulence factors used by Helicobacter pylori to facilitate the development of stomach ulcers? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Polar flagella Production of VacA toxin

Which of the following statements accurately contrasts protozoa and helminths? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Protozoans are single-celled eukaryotes, whereas helminths are multicellular animal parasites. While protozoa are microscopic, helminths have both microscopic and macroscopic life stages.

Your patient presents to your New Mexico clinic with blackened fingertips and toes, along with fever and chills. Which of the following is the most likely diagnosis?

Septicemic plague

Which of the following clinical signs of infection is/are indicative of uncomplicated malaria? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Shivering cold Fever

Your patient from Zambia presents with shivering, fever, sweats, hypotension, headaches, body aches, fatigue, nausea, and vomiting. You presumptively diagnose the patient with malaria and then perform a liver biopsy. Which of the following forms of the malarial parasite would you most likely observe within the patient's liver biopsy?

Sporozoites within infected liver cells, and merozoites emerging from affected, lysed liver cells.

Your patient is experiencing vaginosis. Which of the following conclusions can you draw based on the patient's condition?

The condition is the result of a polymicrobial dysbiosis involving a decrease in vaginal lactobacilli and a concomitant increase in mixed anaerobes.

Which of the following statements concerning the urinary microbiome is/are true? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

The dominant microbial species of urinary microbiome differ depending on what part of the urinary tract is being considered. The urinary microbiome is diverse and varies significantly based on many factors, including age, sex, and general patient health. Urinary microbiome shifts may influence disease progression.

Which of the following statements concerning pneumococcal meningitis is/are true? To be marked correct, you'll need to select all true statements, as there may be more than one correct answer.

The immune response to the pathogen is often the most damaging aspect of the disease. Pneumococcal meningitis typically begins when normal flora spread from the nose and throat into the bloodstream. Pneumococcal meningitis is preventable by vaccination.

Which of the following statements concerning Hepatitis C is/are correct? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

The majority of infected patients develop chronic infections. The majority of chronically infected patients are not diagnosed until the latter stages of the disease.

Which of the following statements accurately describes a chronic Hepatitis B viral infection?

Chronic Hepatitis B viral infections can promote cirrhosis and hepatocellular carcinomas.

Which of the following statements accurately compares foodborne infections to food poisoning?

Foodborne infections are due to pathogen establishment, whereas food poisoning is a toxigenic infection.

Which of the following statements concerning genital herpes is/are correct? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Genital herpes infections are persistent and exhibit latency. Patients infected with genital herpes typically exhibit mild disease symptoms or are asymptomatic.

Which of the following is a plausible mechanism for contracting pseudomembranous colitis?

Heavy antibiotic usage

Which of the following statements is true concerning a patient with an acute HIV infection?

Inability to detect HIV antibody in the patient's serum

Which of the following is/are a valid outcome of Human T Lymphotropic Virus (HTLV)-1 infection? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Infected T cells may produce abundant interferon, creating inflammatory responses to the central nervous system and myelopathy. Adult T cell leukemia.

Which of the following is the most likely pattern of transmission for toxoplasmosis?

Ingesting undercooked meat containing T. gondii cysts.

Which anatomical part of the heart delivers unoxygenated blood to the lungs?

Right ventricle

Which of the following microorganisms is a TORCH agent?

Toxoplasma gondii

Which of the following provides the best definition for the term dysentery?

Diarrhea accompanied by pain, blood, and/or mucus

Which of the following statements concerning neonatal herpes is/are true? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Administering antiviral drugs early on can prevent the virus from spreading to the central nervous system or progressing to a full-blown disseminated infection. Neonatal herpes symptoms typically present within the first month of life.

Which of the following statements is true concerning the life cycle of Giardia lamblia?

After ingestion, a Giardia lamblia cyst hatches into two trophozoites in the small intestine.

Your patient is an otherwise healthy 40-year old male who presents with high fever, severe abdominal pain, and shaking chills. An abdominal ultrasound confirms the presence of several liver abscesses. The patient notes that the week prior, he had dysentery. The patient is thought to have contracted the pathogen at a Florida waterpark three weeks ago. Based on the patient's clinical presentation and case history, which of the following diseases did your patient most likely contract?

Amoebiasis

Which of the following statements accurately describes a sensory neuron?

An afferent neuron specializing in input such as converting environmental stimuli into electrical impulses.

A twenty-year old teenage patient presents with intense vaginal itching, burning, and a "cottage cheese-like" discharge. The patient's case history reveals that she was prescribed amoxicillin for treatment of a severe sinus infection. Which of the following treatments should be prescribed for the patient based on disease presentation and the patient's case history?

An antifungal azole drug should be prescribed.

Botulism Antitoxin Heptavalent (BAT) is given as treatment for symptomatic botulism or as prophylaxis following suspected exposure to botulism. Given Clostridium botulinum's pathogenesis, which of the following does BAT help to prevent?

BAT prevents toxin from binding to nerve cells, alleviating the blocked release of acetylcholine.

Which of the following explains the mechanism of dental cavity formation?

Biofilms on the surface of the teeth ferment sugars (especially sucrose), and the resulting acid degrades the tooth enamel and damages dentin.

Which of the following clinical signs of infection is indicative of sepsis? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Body temperature above 101°F. Tachypnea (more than 20 breaths per minute).

Which of the following accurately describes the intermediate transmission of yellow fever?

Both human-to-mosquito and monkey-to-mosquito

Which of the following statements concerning gonorrhea is/are correct? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Both men and women infected with Neisseria gonorrhoeae are often asymptomatic. Neonatal exposure to gonorrhea can lead to ophthalmia neonatorum and sepsis.

Which of the following statements regarding catheter-associated urinary tract infections (CAUTIs) is/are true? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

CAUTIs account for a significant number of healthcare-acquired infections. CAUTIs are the most common cause of secondary bloodstream infections that result when bacteria spread from the urinary tract into the bloodstream. Urinary catheters increase the risk of urinary tract infection by providing a surface on which biofilms may grow.

Which of the following statements concerning chancroid is/are true? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Chancroid is more common in men compared to women. Chancroid is a common cofactor for human immunodeficiency virus transmission.

Which of the following statements concerning chlamydia is/are correct? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Chlamydia is relatively easy to treat due to low levels of antimicrobial resistance. Chlamydial complications include pelvic inflammatory disease, perinatal exposure (resulting in bacterial conjunctivitis and/or neonatal pneumonia), or chronic epididymitis.

A young graduate student studying deer habitats in the Northeastern United States presents with fever, a headache, and extreme fatigue. You believe that the patient may have a viral infection, and send her home without any medication. Five days later, the patient is readmitted and presents with a bulls-eye rash. If you do not treat the infection with the recommended antimicrobial therapy, which of the following complications may develop?

Chronic arthritis, neurological problems, irregular heartbeat, and myocarditis

After ingesting contaminated spinach, your patient presents with fever, jaundice, severe abdominal pains, and hemorrhagic diarrhea. You believe that the patient has contracted Enterohemorrhagic Escherichia coli. Which of the following laboratory techniques would be the most useful for identification of the foodborne pathogen?

Cultural analysis of stool sample on sorbitol-MacConkey (SMAC) agar.

Which of the following terms is best defined as an inflammation of the bladder?

Cystitis

Your patient, an 8-year old boy, presents to the emergency room with a stiff neck, seizures, hallucinations, and is later found to be comatose. Two days prior, the patient had complained of severe frontal headache, nausea, fever, and vomiting. The child's mother explained that the boy's symptoms began one day after he went swimming in a warm, freshwater lake. Which of the following terms would most accurately describe your patient's symptoms?

Meningoencephalitis

Which of the following statements concerning human papilloma viruses is/are true? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Most individuals who contract human papilloma virus will self-resolve the infection within 2 years. Most cervical cancers are the result of human papilloma virus infection. Several human papillomavirus vaccines exist, protecting against several strains of the virus.

Which of the following characteristics help to explain why Mycobacterium leprae infects the peripheral nervous system?

Mycobacterium leprae prefers a lower growth temperature.

Which of the following anatomical parts is a muscular tissue that makes up the bulk of the heart?

Myocardium

Which of the following outcomes is observed during Rabies virus pathogenesis?

Negri bodies are a diagnostic sign of Rabies virus infection.

Which of the following statements accurately describes the role that normal flora play with regards to human disease and health? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Normal flora modulate immune responses. Normal flora may impact metabolism, obesity, and the development of certain diseases such as diabetes. Normal flora assist with food digestion and provide essential vitamins and nutrients for the host.

Two days after disembarking on a Caribbean cruise, twenty percent of the passengers aboard an American cruise ship became violently ill with profuse vomiting and diarrhea. Gastrointestinal symptoms lasted up to 3 days. Patients ranged in age from toddler to senior, and the majority of those infected were up-to-date on all vaccinations. Which of the following infections was the most likely cause of illness aboard the ship?

Norovirus gastroenteritis

Which of the following statements concerning Cryptococcus neoformans pathogenesis is/are true? To be marked correct, you'll need to select all true statements, as there may be more than one correct answer.

Once fungal spores enter the lungs, C. neoformans invade macrophages, which then carry the fungus to the lymphatic system. The pathogen's thick polysaccharide capsule shields the fungus from the host immune system. Cryptococcocis is the leading cause of death for individuals with HIV/AIDS.

Which of the following statements concerning the life cycle of Chlamydia trachomatis is correct?

Once inside the body, the Chlamydia trachomatis reticulate body replicates before converting back to the elementary body.

Which of the following statements regarding polio vaccines is true?

One disadvantage of the oral polio vaccine is that immunocompromised individuals can develop illness from the attenuated virus and, in rare circumstances, develop paralytic polio.

Which of the following symptoms is/are observed in pelvic inflammatory disease? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Oophoritis Adhesions Salpingitis

Your twenty-year-old, sexually-active female patient presents with an urgency to urinate, dysuria, pyuria, and pain in the lower abdomen. The patient has a negative urine dipstick test result, but a bacteriological culture has confirmed the presence of a UTI. A Gram stain analysis of the bacteriological culture reveals Gram-positive bacteria. Based on the evidence and the patient's case history, which of the following pathogens is the most likely etiological agent of disease?

Staphylococcus saprophyticus

Which of the following anatomical sites is part of the upper gastrointestinal tract? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Stomach Esophagus

Which of the following clinical symptoms is/are indicative of chikungunya? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Sudden onset of polyarthralgia, fever, headache, vomiting, and rash. Bent and stiff posture of patient.

Which of the following statements is true concerning Trypanosoma bruceii?

T. bruceii subsp. rhodiense produces a more rapid, acute disease than T. bruceii subsp. Gambiense.

Gumma lesions on the skin and bones, heart damage, and neurological symptoms are characteristic of which stage of syphilis?

Tertiary syphilis

Which of the following statements accurately describes the function of the meninges? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

The meninges supply nutrients to the central nervous system. The meninges remove wastes from the central nervous system. The meninges protect the central nervous system from physical shock.

Your patient presents with fever, body aches, rash, vomiting, and nausea. A presumptive diagnosis of dengue fever is made. Assuming that the diagnosis is accurate, which of the following statements is also true concerning this patient?

The patient should be monitored for anemia and be kept hydrated.

Which of the following is a valid difference between the central and peripheral nervous systems?

The peripheral nervous system inputs and transmits information, while the central nervous system integrates and responds to the information received.

Which of the following statements help to explain the pathogenesis of human transmissible spongiform encephalopathy?

The shape of normal host PrpC protein is altered by abnormal PrpSc protein, transforming it into infectious PrpSc protein.

Your patient (an 8-year old girl) presents to the emergency room with a stiff neck, seizures, and hallucinations. The day prior, the patient had high fever, intense headaches, and vomiting. Your patient appears to be up-to-date on all immunizations and denies leaving the country within the past month. The patient's father mentions that just one-week prior, the daughter seemed otherwise healthy and had spent all day at the warm freshwater lake near their house. Three days later, the patient dies from complications and an autopsy is performed. Which of the following protozoan forms would most likely be found in the brain and cerebrospinal fluid?

Trophozoites

Which of the following is the primary distinguishing factor between uncomplicated and complicated urinary tract infections?

Uncomplicated urinary tract infections occur in otherwise healthy individuals with normal urinary tract structure, whereas complicated urinary tract infections usually occur in people with catheters, urinary tract malformations/obstructions, or immune-compromised people.

Which of the following clinical criteria is indicative of vaginosis? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Uniform vaginal discharge with a greyish-white appearance. The presence of a fishy odor after adding potassium hydroxide to a vaginal mucus smear. The presence of epithelial cells with bacteria attached.

Which of the following features of the female reproductive system help to limit infection by pathogenic microorganisms?

Vaginal and cervical mucus is enriched with antimicrobial peptides and lysozyme that combat bacteria.

Vaginal lactobacilli perform which of the following protective functions? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Vaginal lactobacilli release bacteriocidins to limit the growth of competing pathogenic microorganisms. Vaginal lactobacilli produce hydrogen peroxide, limiting the growth of anaerobic microorganisms.

Your 30-year old patient presents to a Florida emergency room with fever, headache, flu-like symptoms, stiff neck, disorientation, and convulsions. You notice that there are several insect bites on her arm, which she tells you are mosquito bites from a camping trip two days ago. Based on the patient's case history and disease presentation, which of the following pathogens did your patient most likely contract?

West Nile virus

Which of the following statements concerning trichomoniasis is/are true? To be marked correct, you'll need to select all applicable statements, as there may be more than one correct answer.

Wet mount preparations can be used to confirm infection. Trichomoniasis is an underdiagnosed, underreported disease.

While working at a clinic in Angola, you attend to a patient who presents with jaundice, high fever, and severe headache. Upon close inspection, several mosquito bites are observed on the patient's arms and legs. Which of the following is the most likely cause of the patient's symptoms?

Yellow fever

Your twenty-year old female patient presents with buboes with areas of necrosis, fever, and enlarged inguinal lymph nodes. Which of the following statements concerning your patient is most likely also true?

Your patient most likely also experienced painless genital lesions and cervicitis at an earlier stage of infection.