Ch. 25/26

Which term refers to an inflammation of the blood vessels?

A. lymphangitis

B. endocarditis

C. pericarditis

D. vasculitis

Vasculitis is an inflammation of the blood vessels, leading to various symptoms depending on the affected areas.

Which of these conditions results in the formation of a bubo?

A. lymphangitis

B. lymphadenitis

C. ischemia

D. vasculitis

Lymphadenitis is a condition characterized by the inflammation of lymph nodes, resulting in the formation of a bubo, which is a swollen, painful lymph node.

Which of the following diseases is caused by a spirochete?

A. tularemia

B. relapsing fever

C. rheumatic fever

D. Rocky Mountain spotted fever

Relapsing fever is caused by the spirochete Borrelia.

What disease is most associated with Clostridium perfringens?

A. endocarditis

B. osteomyelitis

C. gas gangrene

D. rat bite fever

Gas gangrene is a severe infection caused by Clostridium perfringens, characterized by the rapid progression of tissue necrosis and gas formation in the affected muscles.

Which of the following viruses is most widespread in the human population?

A. human immunodeficiency virus

B. Ebola virus

C. Epstein-Barr virus

D. hantavirus

The Epstein-Barr virus is one of the most common viruses that infects humans, often associated with infectious mononucleosis and various other conditions.

A patient at a clinic has tested positive for HIV. Her blood contained 700/µL CD4 T cells and she does not have any apparent illness. Her infection is in which stage?

A. 1

B. 2

C. 3

D. 4

The infection is in stage 1, which is the acute infection stage characterized by a high viral load and some CD4 T cell preservation with no symptoms.

Which of these is the most common form of leishmaniasis?

A. cutaneous

B. mucosal

C. visceral

D. intestinal

Cutaneous leishmaniasis is the most common form, characterized by skin lesions and ulcers caused by the Leishmania parasite.

Which of the following diseases does not involve an arthropod vector?

A. schistosomiasis

B. malaria

C. Chagas disease

D. babesiosis

Schistosomiasis is a disease caused by parasitic worms, primarily transmitted through contaminated water rather than by arthropod vectors.

Which artery carries deoxygenated blood?

A. aorta

B. femoral

C. pulmonary

D. subclavian

The pulmonary artery carries deoxygenated blood from the heart to the lungs for oxygenation, distinguishing it from other arteries that typically carry oxygenated blood.

Which pathogen causes toxic shock syndrome?

A. Enterococcus faecalis

B. Pseudomonas aeruginosa

C. Staphylococcus aureus

D. Vibrio cholerae

Toxic shock syndrome is primarily caused by Staphylococcus aureus, a bacterium that produces toxins leading to severe illness and systemic shock.

What is another name for tularemia?

A. brucellosis

B. rabbit fever

C. toxic shock syndrome

D. Valley fever

rabbit fever

Which of the following infections is transmitted by ticks?

A. brucellosis

B. ehrlichiosis

C. plague

D. rat bite fever

Ehrlichiosis is a disease caused by bacteria transmitted through tick bites, leading to fever, headache, and malaise.

Which of the following is true of lymphatic fluid?

A. It contains erythrocytes.

B. It is sterile.

C. It travels at slower speeds than blood.

D. Its fluid composition is very different from plasma.

C. It travels at slower speeds than blood.

What is a dangerous drop in blood pressure associated with infection called?

A. bacteremia

B. hypotensive shock

C. sepsis

D. septic shock

A dangerous drop in blood pressure associated with infection is called septic shock. It occurs when sepsis leads to very low blood pressure, affecting the body's organs.

Instead of basing diagnosis solely on clinical symptoms and patient history, what common approach is used to confirm a tularemia infection?

A. culturing techniques

B. direct fluorescent antibody microscopic examination

C. light microscopy and Gram staining.

D. phase-contrast microscopy

The common approach used to confirm a tularemia infection is direct fluorescent antibody microscopic examination, which helps identify the presence of the Francisella tularensis bacteria in specimens.

What are buboes?

A. abscesses within blood vessels

B. abscesses within lungs

C. infected swellings involving follicles

D. inflamed, swollen lymph nodes

Buboes are inflamed, swollen lymph nodes that commonly occur in lymphatic infections such as the plague. They can become painful and are typically located in the groin, armpit, or neck.

Rocky Mountain spotted fever is most common in which region of the United States?

A. the Midwestern United States, including Minnesota, Iowa, North Dakota, South Dakota, and Wisconsin

B. the northeastern United States, including New York and Connecticut

C. the southeastern United States, including Oklahoma, Arkansas, Tennessee, Missouri, and North Carolina

D. the western United States, including the Rocky Mountains of Colorado and Wyoming

The southeastern United States, including Oklahoma, Arkansas, Tennessee, Missouri, and North Carolina.

How should a tick be removed?

A. It should be covered with petroleum jelly until it releases its hold and can be easily removed.

B. It should be grasped gently with blunt tweezers on the head, near its site of attachment, and pulled very carefully until it releases its grip.

C. It should be grasped gently with tweezers on the tick’s abdomen, then twisted until it comes off.

D. It should be touched with a hot match until it releases its grip, then gently removed, taking care to extract all parts.

To remove a tick, it should be grasped gently with blunt tweezers on the head, near its site of attachment, and pulled very carefully until it releases its grip.

Which of the following conditions is caused by the Epstein-Barr virus?

A. erhlichiosis

B. infectious mononucleosis

C. Rocky Mountain spotted fever

D. yellow fever

Infectious mononucleosis, commonly known as mono, is caused by the Epstein-Barr virus. It is characterized by symptoms such as fatigue, sore throat, fever, and swollen lymph nodes.

Malaria is an important cause of mortality worldwide, making it a significant public health concern. What is the classic presentation of malaria?

A. abrupt development of a dangerously high fever

B. abrupt development of malaise with cycles of chills and high fever, among other symptoms

C. slowly escalating headache, nausea, and vomiting, without fever and with variable other symptoms

D. slowly escalating temperature that reaches dangerously high levels after several days to a week

Abrupt development of malaise with cycles of chills and high fever, among other symptoms.

What is the best approach to treating toxic shock syndrome, a potentially deadly condition?

A. decontamination and debridement without the use of antibiotics, because of the risk of toxin release by dying bacteria

B. decontamination, debridement, vasopressors, and a combination antibiotic therapy such as clindamycin with vancomycin

C. decontamination, debridement, vasoconstrictors, and a combination antibiotic therapy such as clindamycin with daptomycin

D. decontamination, vasopressors, and treatment with a single antibiotic

b. decontamination, debridement, vasopressors, and a combination antibiotic therapy such as clindamycin and vancomycin

Of the 15 known virulence factors for Yersinia pestis, which of the following indicates how many are factors that facilitate attachment to host cells?

A. about one-fourth

B. about one-third

C. only one or two

D. more than half

D. more than half

Pamela spends a day hiking in the woods then finds a tick on her skin that evening. Could the tick have transmitted Lyme disease?

A. Yes, because any contact with an infected tick is sufficient to transmit Lyme disease.

B. Yes, because the tick was probably attached for more than 4 hours.

C. No, because Lyme disease is not transmitted by ticks.

D. No, because the tick was not attached for at least 24 hours.

D. No, because the tick was not attached for at least 24 hours.

An individual is suspected of having malaria on the basis of clinical symptoms. Which steps should a medical professional take to confirm and treat a malaria diagnosis?

A. microscopic analysis of a blood smear and staining, followed by treatment with azithromycin, doxycycline, or tetracycline.

B. microscopic analysis of a blood smear and/or enzyme immunoassay followed by treatment with chloroquine, artemether, atovaquone, or lumefantrine

C. PCR followed by treatment with nifurtimox or benznidazole

D. serological tests followed by treatment with stibogluconate or amphotericin B

B. microscopic analysis of a blood smear and/or enzyme immunoassay followed by treatment with chloroquine, artemether, atovaquone, or lumefantrine.

Match each type of blood condition with the best definition.

Prompts: viremia, bacterernia, toxemia, septicemia

Answers: i. bacteria are reproducing in the blood, iv. toxins are present in the blood, ii. bacteria are present in the blood, iii. viruses are present in the blood

The best definitions are as follows:

viremia - iii. viruses are present in the blood

bacteremia - ii. bacteria are present in the blood

toxemia - iv. toxins are present in the blood;

septicemia - i. bacteria are reproducing in the blood

Match each bacterial disease with its causative agent.

Prompts: rheumatic fever, trench fever, relapsing fever, rabbit fever, Rocky Mountain spotted fever, plague

Answers: iii. Francisella tularensis, ii. Yesinia pestis, v. Borrelia sp., i. Rickettsia rickettsii, vi. Streptococcus pyogenes, iv. Bartonella quintana

The best definitions are as follows:

rheumatic fever - vi. Streptococcus pyogenes

trench fever - iv. Bartonella quintana

relapsing fever - v. Borrelia sp.

rabbit fever - iii. Francisella tularensis

Rocky Mountain spotted fever - i. Rickettsia rickettsii

plague - ii. Yersinia pestis

Match each viral disease with its characteristic symptoms.

Prompts: Ebola virus disease, Burkitt lymphoma, HIV Infection/AIDS, Chikungunya fever, Hantavirus pulmonary syndrome

Answers: v. malignant B-cell tumors and oral hairy leukoplakia, iv. flu-like symptoms followed by a latent period without symptoms, then wasting, and increased susceptibility to opportunistic infections, iii. headache, fever, vomiting, diarrhea, and hemorrhage that may lead to severe bleeding, shock, and organ failure, i. flu-like symptoms that develop into pulmonary edema, hypotension, pneumonia, and shock, ii. blisters, high fever, rash, and joint pain that may last for months

Ebola virus disease - iii. headache, fever, vomiting, diarrhea, and hemorrhage that may lead to severe bleeding, shock, and organ failure

Burkitt lymphoma - v. malignant B-cell tumors and oral hairy leukoplakia

HIV Infection/AIDS - iv. flu-like symptoms followed by a latent period without symptoms, then wasting, and increased susceptibility to opportunistic infections

Chikungunya Fever - ii. blisters, high fever, rash, and joint pain that may last for months

Hantavirus pulmonary syndrome - i. flu-like symptoms that develop into pulmonary edema, hypotension, pneumonia, and shock

Match each disease with the antimicrobial therapy most frequently used for its treatment.

Prompts: babesiosis, schistosomiasis, Chagas disease, leishmaniasis, toxoplasmosis, malaria

Answers: i. stibogluconate or amphotericin B, v. chloroquine, atovaquone, artemether, or lumefantrine, iv. praziquantel, iii. atovaquone and azithromycin or clindamcyin and quinin, ii. nifurtimox or benznidazole, vi. sulfadiazine, pyrimethamine, or spiramycin

babesiosis - iii. atovaquone and azithromycin or clindamycin and quinine
schistosomiasis - iv. praziquantel
Chagas disease - ii. nifurtimox or benznidazole
leishmaniasis - i. stibogluconate or amphotericin B
toxoplasmosis - vi. sulfadiazine, pyrimethamine, or spiramycin
malaria - v. chloroquine, atovaquone, artemether, or lumefantrine

Match each structure with its best definition.

Prompts: myelin sheath, soma, dendrites, synapse, axon

Answers: iii. a gap into which neurotransmitters are released to transmit chemical signals from one cell to another, ii. the long extension of a neuron through which an action potential travels to transmit a signal, i. the main body of a neuron, containing the nucleus and most of the cell’s organelles, iv. a finely branched extension from a neuron that picks up incoming impulses, v. an insulated covering produced by oligodendrites or Schwann cells that speeds the conduction of nervous impulses

myelin sheath: v. an insulated covering produced by oligodendrites or Schwann cells that speeds the conduction of nervous impulses,

soma: i. the main body of a neuron, containing the nucleus and most of the cell’s organelles

dendrites: iv. a finely branched extension from a neuron that picks up incoming impulses

synapse: iii. a gap into which neurotransmitters are released to transmit chemical signals from one cell to another

axon: ii. the long extension of a neuron through which an action potential travels to transmit a signal.

Match each vaccine with its best description.

Prompts: DTaP, Hib vaccine, Sabin vaccine, Salk vaccine

Answers: i. protects against a type of meningitis, ii. a killed virus vaccine that protects against polio, iv. an attenuated virus vaccine that protects against polio, iii. protects against tetanus and two other bacterial infections

DTaP: iii. protects against tetanus and two other bacterial infections,

Hib vaccine: i. protects against a type of meningitis

Sabin vaccine: iv. an attenuated virus vaccine that protects against polio.

Salk vaccine: ii. a killed virus vaccine that protects against polio

Match each type of meningitis with its best description.

Prompts: Cryptococcus meningitis, meningococcal meningitis, viral meningitis, pneumococcal meningitis, Haemophilus influenzae type B meningitis

Answers: v. treated with doxycycline, fluoroquinolones, cephalosporins, or carbapenems, i. generally relatively mild compared with other types of meningitis; caused by a variety of pathogens, ii. can cause a petechial rash and is of particular concern for college students, iv. caused by a fungus, iii. the causative agent is gram positive and lancet shaped

Cryptococcus meningitis: iv. caused by a fungus,
meningococcal meningitis: ii. can cause a petechial rash and is of particular concern for college students,
viral meningitis: i. generally relatively mild compared with other types of meningitis; caused by a variety of pathogens,
pneumococcal meningitis: iii. the causative agent is gram positive and lancet shaped,
Haemophilus influenzae type B meningitis: v. treated with doxycycline, fluoroquinolones, cephalosporins, or carbapenems.

Match each disease with its best description.

Prompts: aspergillosis, leprosy, poliomyelitis, PAM, kuru

Answers: v. prion disease, ii. viral disease, iii. protozoal disease, iv. fungal disease, i. bacterial disease

aspergillosis: iv. fungal disease,

leprosy: i. bacterial disease,

poliomyelitis: ii. viral disease,

PAM: iii. protozoal disease,

kuru: v. prion disease.

Match each disease with its best diagnostic protocol.

Prompts: Hansen’s disease, eastern equine encephalitis, Creutzfeldt-Jakob disease, Zika virus, cryptococcosis

Answers: iv. histological examination of brain biopsy specimens, iii. evaluation of clinical symptoms and new specific virus RNA assay, RT-PCR testing, and MAC-ELISA testing, ii. evaluation of clinical presentation, acid-fast staining, and microscopy of skin biopsy specimens or smears, v. lumbar puncture with negative CSF stain and routine culture, i. evaluation of clinical presentation; serologic testing of serum or CSF

Hansen’s disease: ii. evaluation of clinical presentation, acid-fast staining, and microscopy of skin biopsy specimens or smears,

eastern equine encephalitis: i. evaluation of clinical presentation; serologic testing of serum or CSF,

Creutzfeldt-Jakob disease: iv. histological examination of brain biopsy specimens,

Zika virus: iii. evaluation of clinical symptoms and new specific virus RNA assay, RT-PCR testing, and MAC-ELISA testing,

cryptococcosis: v. lumbar puncture with negative CSF stain and routine culture.

Match each virus with the best description.

Prompts: western equine encephalitis, Japanese encephalitis, eastern equine encephalitis, St. Louis encephalitis, West Nile encephalitis

Answers: iv. transmitted by Culex mosquitoes; birds are a reservoir; became a problem in the United States in 1999, v. worldwide, causes the most cases of vaccine-preventable encephalitis; reservoirs include birds and pigs, iii. carried by three species of Culex mosquitoes; a serious outbreak occurred in 1975, ii. transmitted by Culex tarsalis mosquitoes; has caused relatively few cases in the United States, i. transmitted by Aedes, Coquillettidia, and Culex mosquitoes; birds are reservoirs

western equine encephalitis: ii. transmitted by Culex tarsalis mosquitoes; has caused relatively few cases in the United States,

Japanese encephalitis: v. worldwide, causes the most cases of vaccine-preventable encephalitis; reservoirs include birds and pigs,

eastern equine encephalitis: i. transmitted by Aedes, Coquillettidia, and Culex mosquitoes; birds are reservoirs.

St. Louis encephalitis: iii. carried by three species of Culex mosquitoes; a serious outbreak occurred in 1975

West Nile encephalitis: iv. transmitted by Culex mosquitoes; birds are a reservoir; became a problem in the United States in 1999

Match each strategy for microbial invasion of the CNS with its description.

Prompts: ___ leukocyte-facilitated entry, ___ transcellular entry, ___ nonhematogenous entry, ___ intercellular entry

Answers: iv. pathogen passes between the cells of the blood-brain barrier, ii. pathogen bypasses the blood-brain barrier by travel along the olfactory or trigeminal cranial nerves, i. pathogen gains entry by infecting peripheral white blood cells, iii. pathogen passes through the cells of the blood-brain barrier

leukocyte-facilitated entry: i. pathogen gains entry by infecting peripheral white blood cells,

transcellular entry: iii. pathogen passes through the cells of the blood-brain barrier,

nonhematogenous entry: ii. pathogen bypasses the blood-brain barrier by travel along the olfactory or trigeminal cranial nerves,

intercellular entry: iv. pathogen passes between the cells of the blood-brain barrier.

Which of the following is the innermost membrane surrounding the brain?

A. arachnoid mater

B. dura mater

C. pia mater

D. ventricle mater

C. pia mater

Which of the following is not a common cause of bacterial meningitis?

A. Haemophilus influenzae

B. Neisseria meningitidis

C. Staphylococcus aureus

D. Streptococcus pneumoniae

C. Staphylococcus aureus

Human African trypanosomiasis is transmitted by which of the following?

A. contaminated water

B. mosquitoes

C. ticks

D. tsetse flies

D. tsetse flies

Which of the following statements about antifungal medications is false?

A. They are generally used at low doses.

B. They can only be administered short term.

C. They do not easily cross the blood-brain barrier.

D. They often have strong side effects.

B. They can only be administered short term.

Amoebic keratitis is caused by:

A. Acanthamoeba and Balamuthia

B. Acanthamoeba and Naegleria

C. Balamuthia and Entamoeba

D. Naegleria and Entamoeba

A. Acanthamoeba and Balamuthia

For how long should cryptococcal infections in non-HIV–infected individuals be treated with amphotericin B and flucytosine?

A. a few days

B. about a week

C. at least 10 days

D. at least 10 weeks

D. at least 10 weeks

The central nervous system is made up of

A. sensory organs and muscles.

B. the brain and muscles.

C. the sensory organs and spinal cord.

D. the brain and spinal column.

D. the brain and spinal cord.

Which of the following can NOT be prevented with a vaccine?

A. tetanus

B. pneumococcal meningitis

C. meningococcal meningitis

D. listeriosis

Listeriosis is caused by the bacterium Listeria monocytogenes and is not preventable by vaccination.

Which of these is true of the Sabin but NOT the Salk polio vaccine?

A. requires four injections

B. currently administered in the United States

C. mimics the normal route of infection

D. is an inactivated vaccine

C. mimics the normal route of infection

Which of the following is the causative agent of East African trypanosomiasis?

A. Trypanosoma cruzi

B. Trypanosoma vivax

C. Trypanosoma brucei rhodanese

D. Trypanosoma brucei gambiense

c. Trypanosoma brucei rhodanese

Which of these is the most important cause of adult onset epilepsy?

A. neurocysticercosis

B. neurotoxoplasmosis

C. primary amoebic meningoencephalitis

D. African trypanosomiasis

A. neurocysticercosis is the most important cause of adult onset epilepsy, often resulting from the ingestion of eggs of the Taenia solium parasite.

Before enrolling in college, students are encouraged to undergo vaccination for which of the following diseases?

A. botulism

B. candidiasis

C. listeriosis

D. meningococcal meningitis

D. meningococcal meningitis is a serious bacterial infection that can lead to severe health complications and is recommended for vaccination prior to college enrollment.

What is the outermost membrane surrounding the brain called?

A. pia mater

B. arachnoid mater

C. dura mater

D. alma mater

The outermost membrane surrounding the brain is called the dura mater, which provides protection and support.

Which of the following is not true of Hansen’s disease?

A. It is caused by Mycobacterium leprae.

B. It is highly contagious.

C. It may be transmitted by armadillos.

D. Many humans have natural immunity.

B. It is not highly contagious, as it requires prolonged contact with an infected person for transmission.

Which of the following is usually diagnosed via imaging?

A. African trypanosomiasis

B. arboviral encephalitis

C. neurocysticercosis

D. rabies

C. neurocysticercosis is typically diagnosed using imaging techniques such as MRI or CT scans, which can reveal cysts in the brain.

What is septicemia?

The presence of pathogens or toxins in the blood.

What is sepsis?

The presence of a pathogen in the blood plus inflammation.

What is septic shock?

A huge drop in blood pressure due to a pathogen and inflammation.

What bacteria causes Toxic Shock Syndrome (TSS)?

Staphylococcus aureus

How does Toxic Shock Syndrome typically occur?

Overgrowth of Staphylococcus aureus in women using tampons or contraceptive sponges for too long.

What is endocarditis?

Infection of the internal layers of the heart.

What bacteria is the most common cause of bacterial endocarditis?

Streptococcus mutans from the mouth.

What type of disease is Tularemia?

Zoonotic disease

How is Tularemia transmitted?

By a tick or deer fly bite from an infected animal to a human.

What is a characteristic sign of Tularemia?

An ulcer forming at the site of the injection.

What bacteria causes gas gangrene?

Clostridium perfringens

What is required for gas gangrene to occur?

Dead tissue that allows Clostridium to grow rapidly.

What bacteria causes Cat Scratch Fever?

A bacteria transmitted through a cat scratch.

What is a sign of Cat Scratch Fever?

A papule forming at the site of injection.

What bacteria causes the plague (Black Death)?

Yersinia pestis

How is the plague typically transmitted?

From a flea bite, often from an infected rat.

When can the plague be transmitted from human to human?

Once the individual has a severe case living in their respiratory tract.

What is a characteristic sign of the plague?

Swollen lymph nodes called buboes.

What causes the 'black' in Black Death?

Dark areas of tissue death.

What bacteria causes Lyme disease?

Borrelia burgdorferi

How is Lyme disease transmitted?

By a tick bite.

What is a characteristic sign of Lyme disease?

A bull's eye pattern at the site of injection.

What can Lyme disease lead to if untreated?

Infection of the heart and severe arthritis.

How are hemorrhagic fevers transmitted?

Mosquito bites

What is a common symptom of hemorrhagic fevers?

Excessive bleeding

What protozoan causes Chagas disease?

Trypanosoma

How is Chagas disease transmitted?

By the kissing bug, which defecates while taking a blood meal, and the human scratches the contamination into the mouth or eye.

What are potential outcomes of Chagas disease?

Paralysis of the esophagus and colon, large swollen abdomen, and eventual death if untreated.

What protozoan causes Toxoplasmosis?

Toxoplasma gondii

How is Toxoplasmosis transmitted?

Through contact with cat feces.

Why is Toxoplasmosis dangerous for pregnant women?

It can lead to stillbirth or a baby born with severe neurological damage.

What protozoan causes Malaria?

Plasmodium

How is Malaria transmitted?

By a mosquito bite.

What are the effects of Malaria?

Anemia and cardiovascular collapse due to the destruction of red blood cells.

What characterizes Leishmaniasis?

A nasty lesion on the skin.

How is Schistosomiasis spread?

By human feces or urine in a contaminated water supply.

What is the intermediate host of Schistosoma?

A snail

What are signs of Schistosomiasis?

A swollen abdomen and bleeding of the urethra.

What are the Circulatory & Lymphatic Systems?

Networks of vessels & pump that transport blood & lymph throughout the body

What is/are the primary purpose/s of the circulatory system?

Delivering nutrients, immune factors, & oxygen to tissues & carrying away waste

What role do the kidneys play in the circulatory system?

Filtering blood, removing waste products and eliminating them in urine

What role does the spleen play in the circulatory system?

Filters and stores blood & removes damaged red blood cells and is a reservoir for immune factors

What are the primary lymphoid tissues in the lymphatic system?

Bone marrow & thymus

What are the secondary Lymphoid Tissues in the lymphatic system?

Spleen, lymph nodes, & several areas of diffuse lymphoid tissues underlying epithelial membranes

What is Bacteremia?

Bacteria in the blood

What is Septicemia?

Bacteria reproducing in the blood as they spread

What is Viremia?

Presence of viruses in the blood

What is Endocarditis?

Inflammation of the endocardium or inner heart lining

What is Pericarditis?

Inflammation of the pericardium or sac surrounding the heart

What is Myocarditis?

Inflammation of the heart’s muscle tissue