Chapter 22 Microbial Diseases of the Nervous System My Nursing Test Banks

Microbiology: An Introduction, 12e (Tortora)

Chapter 22   Microbial Diseases of the Nervous System

22.1   Multiple-Choice Questions

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.

D) death ultimately occurs without proper treatment.

E) Trypanosoma brucei gambiense is the more common cause of disease.

Answer:  B

Section:  22.5

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.13

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.

D) the infections move along peripheral nerves.

E) it is very difficult to determine the causative microbe.

Answer:  C

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  22.4

3) All of the following organisms cause meningitis EXCEPT

A) Neisseria meningitidis.

B) Haemophilus influenzae.

C) Cryptococcus neoformans.

D) Streptococcus pneumoniae.

E) Mycobacterium leprae.

Answer:  E

Section:  22.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.2

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.

Answer:  E

Section:  22.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  22.3

Global Outcome:  2

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

E) Naegleria fowleri causes amoebic encephalitis

Answer:  D

Section:  22.4

Blooms Taxonomy:  Comprehension

Learning Outcome:  22.12

Global Outcome:  2

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.

Answer:  E

Section:  22.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  22.8

Global Outcome:  2

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.

D) Diagnosis is based on skin biopsy.

E) The etiologic agent is acid-fast.

Answer:  B

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  22.7

Global Outcome:  2

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

A) Neisseria meningitidis.

B) Haemophilus influenzae.

C) Listeria monocytogenes.

D) Cryptococcus neoformans.

E) None of the answers is correct; all of these organisms are transmitted by the respiratory route.

Answer:  C

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.3

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.

D) Diagnosis is based on immunofluorescent techniques.

E) Average incubation period is 30 to 50 days after initial infection.

Answer:  C

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.8

10) The symptoms of tetanus are due to

A) endospore formation.

B) systemic infection.

C) sustained relaxation of muscles.

D) tetanospasmin.

E) inflammation.

Answer:  D

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.5

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).

E) None of the answers is correct; all of these diseases are caused by arbovirus.

Answer:  D

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.8

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.

D) Streptococcus pneumoniae.

E) Any of these organisms could be the causative agent.

Answer:  A

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  22.3

Global Outcome:  2

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.

D) avoidance of endemic areas.

E) treatment of uninfected humans.

Answer:  C

Section:  22.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  22.11

Global Outcome:  7

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

A) tetanus toxoid.

B) tetanus immune globulin.

C) penicillin.

D) none; no action is necessary.

E) debridement.

Answer:  B

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  3.4

Learning Outcome:  22.5

Global Outcome:  5

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

A) tetanus toxoid.

B) tetanus immune globulin.

C) penicillin.

D) DTaP.

E) debridement.

Answer:  A

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  6.3

Learning Outcome:  22.5

Global Outcome:  5

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.

D) the parenteral route.

E) direct penetration into nerves.

Answer:  B

Section:  22.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.1

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.

D) convulsions.

E) fever, headache, and stiff neck.

Answer:  A

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.4

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.

E) antibodies are not an effective method of treatment.

Answer:  D

Section:  22.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  22.6

Global Outcome:  7

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

D) Hansens disease

E) poliomyelitis

Answer:  A

Section:  22.3

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  22.8

Global Outcome:  2

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.

E) people encounter more bats during warm summer evenings.

Answer:  D

Section:  22.3

Blooms Taxonomy:  Analysis

Learning Outcome:  22.8

Global Outcome:  7

21) Which of the following pairs is mismatched?

A) leprosy direct contact

B) poliomyelitis respiratory route

C) meningococcal meningitis respiratory route

D) rabies direct contact

E) listeriosis ingestion

Answer:  B

Section:  22.3

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  22.8

Global Outcome:  2

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

D) check serum antibodies

E) None of these would provide rapid identification.

Answer:  A

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  8.3

Learning Outcome:  22.4

Global Outcome:  2

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.

Answer:  E

Section:  22.6

Blooms Taxonomy:  Analysis

Learning Outcome:  22.14

Global Outcome:  2

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

E) None of the answers are correct; all these characteristics are correctly matched.

Answer:  D

Section:  22.3

Blooms Taxonomy:  Analysis

ASMcue Outcome:  6.3

Learning Outcome:  22.9

Global Outcome:  5

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

D) examination of local mosquitoes

E) complement fixation test for IgG antibodies

Answer:  A

Section:  22.3

Blooms Taxonomy:  Analysis

ASMcue Outcome:  8.3

Learning Outcome:  22.8

Global Outcome:  2

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.

D) it often begins with flu-like symptoms that do not go away.

E) it may be triggered by a viral infection.

Answer:  C

Section:  22.7

Blooms Taxonomy:  Knowledge

Learning Outcome:  22.15

27) A physician diagnoses a patient with lepromatous Hansens 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.

E) infection probably occurred as a result of prolonged contact with another infected individual.

Answer:  D

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.7

28) Arboviruses cause ________ and are transmitted by ________.

A) meningitis; bee stings

B) meningitis; mosquitoes

C) encephalitis; dog bites

D) encephalitis; mosquitoes

E) both meningitis and encephalitis; mosquitoes

Answer:  D

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.8

29) Naegleria fowleri meningoencephalitis is commonly acquired by

A) exposure to bird droppings.

B) mosquito bites.

C) swimming in warm ponds or streams.

D) ingestion of water contaminated with fecal material.

E) exposure to body fluids of a contaminated individual.

Answer:  C

Section:  22.5

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.13

30) Diagnosis of rabies is confirmed by

A) Gram stain.

B) direct fluorescent-antibody test.

C) patients symptoms.

D) passive agglutination.

E) patients death.

Answer:  B

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  8.3

Learning Outcome:  22.8

31) Which of the following is treated with antibiotics?

A) botulism

B) tetanus

C) streptococcal pneumonia

D) polio

E) All of these diseases can be successfully treated with antibiotics.

Answer:  C

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  3.4

Learning Outcome:  22.4

Global Outcome:  7

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

D) California encephalitis

E) West Nile encephalitis

Answer:  B

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.8

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

E) Entamoeba and Naegleria

Answer:  D

Section:  22.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  22.13

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

A) Haemophilus

B) Listeria

C) Naegleria

D) Neisseria

E) Streptococcus

Answer:  B

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  22.4

Global Outcome:  2

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.

Answer:  E

Section:  22.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  22.6

Global Outcome:  7

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.

Answer:  E

Section:  22.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  22.10

Global Outcome:  5

37) Vaccination is available for all the following EXCEPT

A) Haemophilus meningitis.

B) Neisseria meningitis.

C) tetanus.

D) rabies.

E) botulism.

Answer:  E

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  22.6

Global Outcome:  5

38) Patients with leprosy usually die from complications such as

A) brain damage.

B) loss of nerve function.

C) tuberculosis.

D) pneumonia.

E) cardiac arrest.

Answer:  C

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.7

39) All of the following are acquired by ingestion EXCEPT

A) botulism.

B) cryptococcosis.

C) listeriosis.

D) poliomyelitis.

E) Creutzfeldt-Jakob disease.

Answer:  B

Section:  22.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.12

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.

E) a prion.

Answer:  D

Section:  22.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  22.3

Global Outcome:  2

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

D) rabies virus destroys cells of the CNS

E) leprosy deformation of nose and hands can occur

Answer:  B

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.6

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

A) protozoa.

B) virus.

C) fungi.

D) bacteria.

E) mosquitoes.

Answer:  E

Section:  22.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.2

Global Outcome:  2

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

D) Haemophilus influenzae capsule vaccine

E) meningococcal capsule vaccine

Answer:  B

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  6.3

Learning Outcome:  22.9

Global Outcome:  7

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.

Answer:  E

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.7

Global Outcome:  2

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.

D) the majority of cases are asymptomatic.

E) the oral polio vaccine contains attenuated strains of the virus.

Answer:  C

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.8

22.2   True/False Questions

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

Answer:  FALSE

Section:  22.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  22.1

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

Answer:  TRUE

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.4

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

Answer:  FALSE

Section:  22.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  22.6

Global Outcome:  7

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

Answer:  FALSE

Section:  22.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  22.8

Global Outcome:  2

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.

Answer:  TRUE

Section:  22.6

Blooms Taxonomy:  Comprehension

Learning Outcome:  22.14

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

Answer:  TRUE

Section:  22.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.8

Global Outcome:  2

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

Answer:  TRUE

Section:  22.3

Blooms Taxonomy:  Knowledge

Learning Outcome:  22.7

Global Outcome:  7

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.

Answer:  FALSE

Section:  22.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  22.3

Global Outcome:  2

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

Answer:  TRUE

Section:  22.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  22.5

Global Outcome:  2

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

Answer:  FALSE

Section:  22.4

Blooms Taxonomy:  Knowledge

Learning Outcome:  22.12

Global Outcome:  2

22.3   Essay Questions

1) There is an antitoxin for botulism. Why, then, is the outcome of botulism often fatal?

Section:  22.2

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.3a

Learning Outcome:  22.6

Global Outcome:  8

2) Discuss the advantages and disadvantages of the Salk and Sabin vaccines.

Section:  22.3

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.3a

Learning Outcome:  22.9

Global Outcome:  8

3) Explain the transmission and etiology of meningococcal meningitis.

Section:  22.2

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.3a

Learning Outcome:  22.3

Global Outcome:  8

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