1) 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.

B

2) Bacterial encephalitis and meningitis are difficult to treat because

A) no medications exist for treatment of these infections.

B) antibiotics damage nervous tissue.

C) many antibiotics cannot penetrate the blood-brain barrier.

C

3) All of the following organisms cause meningitis EXCEPT

A) Neisseria meningitidis.

B) Haemophilus influenzae.

C) Cryptococcus neoformans.

D) Streptococcus pneumoniae.

E) Mycobacterium leprae.

E

4) Which of the following statements about Neisseria meningitis is FALSE?

A) A healthy carrier state can exist.

B) It is encapsulated.

C) It is typically transmitted by droplet aerosols or direct contact with secretions.

D) Its most distinguishing feature is a unique rash.

E) It is a gram-positive anaerobe.

E

5) Which of the following pairs is mismatched?

A) Neisseria meningitidis — produces deadly endotoxins

B) Haemophilus influenzae — virulence due to capsule

C) Mycobacterium leprae — cultured in armadillos

D) Cryptococcus neoformans — acid-fast rod

D

6) All of the following organisms are correctly matched to the recommended treatment EXCEPT

A) Neisseria meningitidis — cephalosporins.

B) Haemophilus influenzae — cephalosporins.

C) Cryptococcus neoformans — amphotericin B.

D) Mycobacterium leprae — dapsone.

E) poliovirus — amphotericin B.

E

7) Which of the following statements about leprosy is FALSE?

A) It is rarely fatal.

B) Patients with leprosy must be isolated.

C) It is transmitted by direct contact.

B

8) All of the following organisms are transmitted via the respiratory route EXCEPT

A) Neisseria meningitidis.

B) Haemophilus influenzae.

C) Listeria monocytogenes.

C

9) Which of the following statements about rabies is FALSE?

A) It is caused by Lyssavirus.

B) Hydrophobia is associated with the disease.

C) Most infections in the U.S. are the result of bites from infected dogs.

C

10) The symptoms of tetanus are due to

A) endospore formation.

B) systemic infection.

C) sustained relaxation of muscles.

D) tetanospasmin.

D

11) All of the following diseases are caused by arbovirus EXCEPT

A) St. Louis encephalitis.

B) eastern equine encephalitis.

C) West Nile encephalitis.

D) primary amebic meningoencephalitis (PAM).

D

12) A 30-year-old woman was hospitalized after she experienced convulsions. On examination, she was alert and oriented and complained of a fever, headache, and stiff neck. Any of the following organisms could be responsible for her symptoms EXCEPT

A) Clostridium botulinum.

B) Listeria monocytogenes.

C) Haemophilus influenza.

A

13) The most effective control of mosquito-borne disease is

A) treatment of infected humans.

B) treatment of infected wild animals.

C) elimination of the mosquito population.

C

14) Initial treatment for tetanus in an unimmunized person with a puncture wound is

A) tetanus toxoid.

B) tetanus immune globulin.

C) penicillin.

B

15) Initial treatment for tetanus in a fully immunized person with a puncture wound is

A) tetanus toxoid.

B) tetanus immune globulin.

C) penicillin.

A

16) The most common route of central nervous system invasion by pathogens is through

A) the skin.

B) the circulatory system.

C) the gastrointestinal system.

B

17) The prodromal (i.e. pre-acute disease stage) symptoms of bacterial meningitis is/are

A) mild cold symptoms.

B) fever and headache.

C) stiff neck and back pains.

A

18) All of the following are associated with botulism outbreaks EXCEPT

A) type A toxin is most virulent.

B) endospores of C. botulinum have been recovered from honey.

C) type E toxin is associated with seafood.

D) Alaskan natives have the lowest rate of botulism in the world.

D

19) A pathologist detects Negri bodies while examining a brain section taken at autopsy. What was the cause of death?

A) rabies

B) meningococcal meningitis

C) eastern equine encephalitis

A

20) Encephalitis is more common in the summer months because

A) pathogens are present in swimming pools and lakes.

B) ameba populations increase in swimming pools.

C) ticks are encountered while hiking in the woods.

D) mosquito populations increase.

D

21) Which of the following pairs is mismatched?

A) leprosy — direct contact

B) poliomyelitis — respiratory route

C) meningococcal meningitis — respiratory route

B

22) A 30-year-old woman was hospitalized after she experienced convulsions. On examination, she was alert and oriented and complained of a fever, headache, and stiff neck. Which of the following is most likely to provide rapid identification of the cause of her symptoms?

A) Gram stain of cerebrospinal fluid

B) Gram stain of throat culture

C) biopsy of brain tissue

A

23) Each of the following is caused by prions EXCEPT

A) sheep scrapie.

B) kuru.

C) Creutzfeldt-Jakob disease.

D) bovine spongiform encephalopathy.

E) rabies.

E

24) Which of the following vaccine characteristics is (are) mismatched with their respective vaccine type?

A) 1, 3, and 5

B) 4, 5, and 6

C) 1 and 3 only

D) 2 only

D

25) An eight-year-old girl in rural Wisconsin has chills, headache, and fever and reports having been bitten by mosquitoes. How would you confirm your diagnosis of arboviral encephalitis?

A) ELISA test for IgM antibodies

B) brain biopsy for Negri bodies

C) Gram stain of cerebrospinal fluid

A

26) All of the following are true of chronic fatigue syndrome EXCEPT

A) it may have a genetic component.

B) it is also known as myalgic encephalomyelitis.

C) it is a psychological disorder.

C

27) A physician diagnoses a patient with lepromatous Hansen's disease. All of the following pertain to the patient EXCEPT

A) disfiguring nodules form all over the body.

B) the disease has progressed from the tuberculoid stage.

C) a skin biopsy will be taken to aid diagnosis.

D) treatment will include injections of penicillin.

D

28) Arboviruses cause ________ and are transmitted by ________.

A) meningitis; bee stings

B) meningitis; mosquitoes

C) encephalitis; dog bites

D) encephalitis; mosquitoes

D

29) Naegleria fowleri meningoencephalitis is commonly acquired by

A) exposure to bird droppings.

B) mosquito bites.

C) swimming in warm ponds or streams.

C

30) Diagnosis of rabies is confirmed by

A) Gram stain.

B) direct fluorescent-antibody test.

C) patient's symptoms.

B

31) Which of the following is treated with antibiotics?

A) botulism

B) tetanus

C) streptococcal pneumonia

C

32) Which one of the following causes the most severe illness in humans, with a mortality rate of 30 percent?

A) western equine encephalitis

B) eastern equine encephalitis

C) St. Louis encephalitis

B

33) Which of the following is/are a free-living amoeba that can cause encephalitis?

A) Acanthamoeba

B) Naegleria

C) Entamoeba

D) Naegleria and Acanthamoeba

D

34) Microscopic examination of cerebrospinal fluid reveals gram-positive rods. What is the organism?

A) Haemophilus

B) Listeria

C) Naegleria

B

35) On June 30, a 47-year-old man was hospitalized with dizziness, blurred vision, slurred speech, difficulty swallowing, and nausea. Examination revealed facial paralysis. 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) antibiotics.

B) toxin.

C) surgery.

D) vaccination.

E) supportive care, including respiratory assistance.

E

36) 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) human diploid cell vaccine.

C) immune globulin injections.

D) antiviral medications.

E) postexposure prophylaxis.

E

37) Vaccination is available for all the following EXCEPT

A) Haemophilus meningitis.

B) Neisseria meningitis.

C) tetanus.

D) rabies.

E) botulism.

E

38) Patients with leprosy usually die from complications such as

A) brain damage.

B) loss of nerve function.

C) tuberculosis.

C

39) All of the following are acquired by ingestion EXCEPT

A) botulism.

B) cryptococcosis.

C) listeriosis.

B

40) 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) Neisseria meningitidis.

B) rabies.

C) Clostridium tetani.

D) Haemophilus influenzae.

D

41) Which of the following pairs is mismatched?

A) tetanus — releases potent neurotoxin

B) botulism — stimulates transmission of nerve impulse

C) poliomyelitis — multiplication of virus occurs in throat and small intestine

B

42) All of the following microorganisms can directly cause meningitis EXCEPT

A) protozoa.

B) virus.

C) fungi.

D) bacteria.

E) mosquitoes.

E

43) Which of the following vaccines can cause the disease it is designed to prevent?

A) tetanus toxoid vaccine

B) oral polio vaccine

C) inactivated polio vaccine

B

44) All of the following are true of M. leprae EXCEPT

A) it grows best at temperatures below 37° C.

B) it survives ingestion by macrophages.

C) it invades cells of the PNS.

D) it can be cultured in armadillos.

E) it has a very short generation time of approximately twelve hours.

E

45) All of the following are true of poliomyelitis EXCEPT

A) infection is due to ingestion of contaminated water.

B) initial sites of viral replication are the throat and small intestine.

C) most cases result in muscle paralysis.

C

1) CSF contains high levels of complement and circulating antibodies to prevent infection of the brain and spinal cord.

FALSE

2) Viral meningitis is much more common than bacterial meningitis and tends to cause a milder form of disease.

TRUE

3) Lifelong immunity is conferred once an individual has had botulism and recovered.

FALSE

4) Poliomyelitis is caused by a virus and usually leads to paralysis in those affected.

FALSE

5) If a normal protein typically found on the surface of nervous tissue cells comes into contact with an abnormally folded protein, it can lead to prion-related disease.

TRUE

6) The most common host of the virus causing eastern equine encephalitis is horses.

TRUE

7) The number of leprosy cases in the United States is gradually increasing.

TRUE

8) Autopsy of a stillborn fetus reveals the cause of death to be meningitis. Cultures show the presence of a gram-positive rod. The likely pathogen is Haemophilus influenza.

FALSE

9) Botulism and tetanus are caused by bacterial endospores commonly found in the soil.

TRUE

10) Cryptococcus neoformans is a gram-negative cocci with a thick capsule.

FALSE