Chapter 23 Microbial Diseases of the Cardiovascular and Lymphatic Systems My Nursing Test Banks

Microbiology: An Introduction, 12e, (Tortora)

Chapter 23   Microbial Diseases of the Cardiovascular and Lymphatic Systems

23.1   Multiple-Choice Questions

1) Which of the following statements about sepsis is FALSE?

A) Symptoms include fever and decreased blood pressure.

B) Lymphangitis may occur.

C) It can be treated with antibiotics.

D) It usually is caused by gram-positive bacteria.

E) It may be aggravated by antibiotics.

Answer:  D

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.2

2) Which of the following pairs is mismatched?

A) subacute bacterial endocarditis alpha-hemolytic streptococci

B) acute bacterial endocarditis Staphylococcus aureus

C) pericarditis Streptococcus pyogenes

D) puerperal sepsis Staphylococcus aureus

E) Burkitts lymphoma Epstein-Barr virus

Answer:  D

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.3

3) Which of the following is NOT a recognized form of anthrax?

A) cutaneous

B) inhalationial

C) septic

D) gastrointestinal

E) None of the answers are correct; all of these are recognized forms of anthrax.

Answer:  C

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.7

4) Which of the following is NOT typically treated with penicillin?

A) serious wounds at risk for gas gangrene

B) tularemia

C) patients at risk for rheumatic fever

D) puerperal sepsis

E) rat-bite fever

Answer:  B

Section:  23.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  23.5

Global Outcome:  5

5) Which of the following statements about tularemia is FALSE?

A) It is caused by Francisella tularensis.

B) The most common reservoir is rabbits.

C) It may be transmitted by arthropods.

D) It may be transmitted by direct contact.

E) It occurs only in California.

Answer:  E

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.5

6) Which of the following is a symptom of brucellosis?

A) gastroenteritis

B) relapsing fever

C) undulant fever

D) pneumonia

E) jaundice

Answer:  C

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.6

7) Which of the following is NOT transmitted in raw milk?

A) toxoplasmosis

B) anthrax

C) brucellosis

D) listeriosis

E) All of these can be transmitted in raw milk.

Answer:  A

Section:  23.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.16

Global Outcome:  7

8) Which of the following is NOT a characteristic of Bacillus anthracis?

A) is aerobic

B) is gram-positive

C) forms endospores

D) found in soil

E) produces endotoxins

Answer:  E

Section:  23.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.7

9) The symptoms of gas gangrene are due to all of the following EXCEPT

A) microbial fermentation.

B) necrotizing exotoxins.

C) proteolytic enzymes.

D) hyaluronidase.

E) endocarditis

Answer:  E

Section:  23.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.8

Global Outcome:  7

10) Which of the following bacterial infections CANNOT be transmitted by dog or cat bites?

A) Pasteurella multocida

B) Streptobacillus

C) Bartonella henselae

D) Fusobacterium

E) None of the answers is correct; all of these bacterial infections can be transmitted by dog or cat bites.

Answer:  B

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.9

11) Which of the following pairs is mismatched?

A) malaria Anopheles (mosquito)

B) dengue Aedes (mosquito)

C) epidemic typhus Pediculus (louse)

D) Rocky Mountain spotted fever Dermacentor (tick)

E) encephalitis Ixodes (tick)

Answer:  E

Section:  23.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.11

12) Unsanitary and crowded conditions increase the incidence of all of the following diseases EXCEPT

A) plague.

B) epidemic typhus.

C) endemic murine typhus.

D) Rocky Mountain spotted fever.

E) relapsing fever.

Answer:  D

Section:  23.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.10

Global Outcome:  5

13) Which of the following statements about toxoplasmosis is FALSE?

A) It is caused by a protozoan.

B) The reservoir is cats.

C) It is transmitted by the gastrointestinal route.

D) It is a severe illness in adults.

E) It can be congenital.

Answer:  D

Section:  23.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.16

14) Which of the following pairs does NOT apply to Chagas disease?

A) causative agent Trypanosoma cruzi

B) vector kissing bug

C) reservoir rodents

D) diagnosis of acute phase serological tests for antibodies

E) treatment nifurtimox

Answer:  D

Section:  23.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.16

15) Which of the following is NOT caused by a bacterium?

A) epidemic typhus

B) tickborne typhus

C) malaria

D) plague

E) relapsing fever

Answer:  C

Section:  23.4

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.16

16) A patient presents with inflammation of the heart valves, fever, malaise, and subcutaneous nodules at joints. The recommended treatment is

A) supportive care.

B) streptomycin.

C) chloroquine.

D) hyperbaric chamber.

E) praziquantel.

Answer:  A

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.4

17) Which of the following statements about puerperal sepsis is FALSE?

A) It is transmitted from mother to fetus.

B) It is caused by health care personnel.

C) It begins as a focal infection.

D) It is a complication of abortion or childbirth.

E) Its frequency of occurrence has decreased because of antibiotics and aseptic techniques.

Answer:  A

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.3

18) Which of the following statements about schistosomiasis is FALSE?

A) The cercariae penetrate human skin.

B) They symptoms are caused by immune reactions to the eggs shed in the human host.

C) The intermediate host is an aquatic snail.

D) It is caused by a roundworm.

E) The female worm lives in a groove that runs down the body of the male.

Answer:  D

Section:  23.5

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.18

19) Which of the following statements about rheumatic fever is FALSE?

A) It is a complication of a group A beta-hemolytic streptococcal infection.

B) It is an inflammation of the heart.

C) It is an inflammation of the joints.

D) It is rarely fatal, even when untreated.

E) The incidence has declined in the last ten years.

Answer:  D

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.4

20) Which of the following pairs is mismatched?

A) Rickettsia intracellular parasite

B) Brucella gram-negative aerobic rods

C) Francisella gram-positive facultatively anaerobic pleomorphic bacillus

D) Bacillus gram-positive endospore-forming rods

E) None of the pairs is mismatched.

Answer:  C

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.5

21) Which of the following can be transmitted from an infected mother to her fetus across the placenta?

A) Borrelia

B) cytomegalovirus

C) Spirillum

D) anthrax

E) Yersinia

Answer:  B

Section:  23.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.13

22) Which of the following pairs is mismatched?

A) Borrelia relapsing fever

B) Yersinia plague

C) Streptobacillus rat-bite fever

D) Pasteurella cat-scratch disease

E) Spirillum rat-bite fever

Answer:  D

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.9

23) A patient returning from an extended trip into Mexico has the following symptoms: a papule at the site of a previous bug bite and enlarged lymph nodes. Microscopic examination of the papule reveals nucleated cells in white blood cells. The patient most likely has

A) anthrax.

B) brucellosis.

C) leishmaniasis.

D) malaria.

E) schistosomiasis.

Answer:  C

Section:  23.4

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  23.16

Global Outcome:  2

24) Human-to-human transmission of plague is usually by

A) rat flea.

B) dog flea.

C) the respiratory route.

D) wounds.

E) unsanitary conditions.

Answer:  C

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.10

25) A characteristic symptom of plague is

A) small red spots on the skin.

B) swollen lymph nodes.

C) rose-colored spots.

D) recurrent fever.

E) nausea and vomiting.

Answer:  B

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.10

26) Which of the following pairs regarding the epidemiology of malaria is mismatched?

A) vector Ixodes

B) etiology Plasmodium

C) found in liver sporozoites

D) diagnosis presence of merozoites

E) treatment chloroquine when possible

Answer:  A

Section:  23.4

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.16

27) A predisposing factor for infection by Clostridium perfringens is

A) gangrene.

B) burns.

C) debridement.

D) hyperbaric treatment.

E) an infected finger.

Answer:  A

Section:  23.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.8

28) Which of the following is NOT a zoonosis?

A) puerperal sepsis

B) Hantavirus infection

C) anthrax

D) brucellosis

E) tularemia

Answer:  A

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.3

29) Arthropods can serve as a reservoir for all of the following diseases EXCEPT

A) plague.

B) brucellosis.

C) epidemic typhus.

D) yellow fever.

E) malaria.

Answer:  B

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.6

30) Which of the following pairs is mismatched?

A) cat-scratch disease malignant pustule developing into septicemia

B) brucellosis a temperature of 40C each evening

C) tularemia a localized infection appearing as a small ulcer

D) Borrelia rash and flulike

E) toxoplasmosis congenital brain damage

Answer:  A

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.9

31) Which of the following CANNOT be transmitted to humans from domestic cats?

A) toxoplasmosis

B) plague

C) Chagas disease

D) Bartonella

E) None of the answers is correct; all of these diseases can be transmitted to humans from domestic cats.

Answer:  C

Section:  23.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.10

32) Which of the following is the same for both relapsing fever and undulant fever?

A) rising and falling body temperature

B) mode of transmission

C) presence of rash

D) reservoir

E) etiology

Answer:  A

Section:  23.2

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.11

33) Which of the following is NOT treated with antibiotics?

A) plague

B) tularemia

C) Lyme disease

D) Ebola

E) anthrax

Answer:  D

Section:  23.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  23.15

Global Outcome:  7

34) Which of the following produces a permanent carrier state following infection?

A) Borrelia

B) cytomegalovirus

C) Spirillum

D) Toxoplasma

E) Yersinia

Answer:  B

Section:  23.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.13

35) Epstein-Barr virus has been implicated in all of the following EXCEPT

A) endocarditis.

B) infectious mononucleosis.

C) Burkitts lymphoma.

D) nasopharyngeal carcinoma.

E) Hodgkins disease.

Answer:  A

Section:  23.3

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.13

36) Which of the following leads to all the others?

A) subcutaneous hemorrhaging

B) presence of antirickettsial antibodies

C) blockage of capillaries

D) bacterial growth in endothelial cells

E) breakage of capillaries

Answer:  D

Section:  23.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  23.10

Global Outcome:  2

37) A patient complains of fever, severe muscle and joint pain, and a rash. The patient reports returning from a Caribbean vacation one week ago. Which of the following do you suspect?

A) Lassa fever

B) dengue

C) Hantavirus hemorrhagic fever

D) typhus

E) yellow fever

Answer:  B

Section:  23.3

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  23.13

Global Outcome:  2

38) Which of the following pairs is NOT correctly matched for Gram reaction?

A) Lyme disease gram-negative

B) tularemia gram-negative

C) anthrax gram-positive

D) Rocky Mountain spotted fever gram-negative

E) Ehrlichia gram-positive

Answer:  E

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  2.1

Learning Outcome:  23.11

39) Scrapings from a patients rash reveal cercariae. The disease is most likely

A) Lyme disease.

B) Rocky Mountain spotted fever.

C) relapsing fever.

D) swimmers itch.

E) Chagas disease.

Answer:  D

Section:  23.5

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.18

40) You advise your pregnant friend to not adopt a new kitten from her neighbor because she could contract

A) plague.

B) Brukitts Lymphoma.

C) toxoplasmosis.

D) listeriosis.

E) infectious mononucleosis.

Answer:  C

Section:  23.4

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  23.16

41) Which of the following is evidence that the arthritis afflicting children in Lyme, Connecticut, was due to bacterial infection?

A) treatable with penicillin

B) not contagious

C) accompanied by a rash

D) affected mostly children

E) transmitted by ticks

Answer:  A

Section:  23.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  23.10

Global Outcome:  2

42) Which of the following is NOT controlled by a mosquito eradication program?

A) chikungunya fever

B) yellow fever

C) dengue fever

D) schistosomiasis

E) malaria

Answer:  D

Section:  23.5

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  23.18

Global Outcome:  5

43) A 62-year-old man was hospitalized with an eight-day history of fever, chills, sweats, and vomiting. His temperature on admission was 40C (104F). A routine peripheral blood smear revealed ring-shaped bodies in the RBCs. What treatment would you prescribe?

A) hyperbaric oxygen

B) mefloquine

C) no treatment

D) penicillin

E) streptomycin

Answer:  B

Section:  23.4

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  23.16

Global Outcome:  2

44) Which of the following statements about group B streptococci is FALSE?

A) They are present in healthy carriers.

B) They cause gram-positive sepsis.

C) They cause strep throat.

D) They cause neonatal sepsis.

E) They are classified as Streptococcus agalactiae.

Answer:  C

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.3

45) Brucella bacteria are considered a potential agent of bioterrorism because

A) they are not susceptible to antibiotics.

B) they easily become airborne.

C) infection causes a fever.

D) it is a endospore-forming organism.

E) it causes ulcerating lesions of the skin.

Answer:  B

Section:  23.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  23.6

Global Outcome:  2

23.2   True/False Questions

1) All lymph that returns to the heart must pass through at least one lymph node.

Answer:  TRUE

Section:  23.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  23.1

2) Lymph contains red blood cells.

Answer:  FALSE

Section:  23.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  23.1

3) Pathogens must be blood-borne in order to initiate sepsis.

Answer:  FALSE

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.2

4) Neonatal sepsis is most commonly caused by group A streptococci.

Answer:  FALSE

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.2

5) Subacute bacterial endocarditis is commonly the result of infections initially focused on the oral cavity.

Answer:  TRUE

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.4

6) All viral hemorrhagic fever outbreaks have been confined to the Eastern Hemisphere.

Answer:  FALSE

Section:  23.3

Blooms Taxonomy:  Comprehension

Learning Outcome:  23.15

7) Netting modified for sandflies should also be useful in preventing malaria.

Answer:  TRUE

Section:  23.4

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  23.16

8) Tularemia is considered to be a potential bioterrorism agent due its high infective dose.

Answer:  FALSE

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.5

9) All forms of typhus are associated with arthropod vectors.

Answer:  TRUE

Section:  23.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  23.12

10) The most likely primary site of replication during mononucleosis is the B lymphocyte.

Answer:  TRUE

Section:  23.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  4.4

Learning Outcome:  23.13

23.3   Essay Questions

1) Humans are not the normal hosts for Ixodes and Xenopsylla. How, then, do humans contract Lyme disease and plague?

Section:  23.2

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  5.4

Learning Outcome:  23.12

Global Outcome:  8

2) On June 1, a 32-year-old hiker was bitten by a tick. After one week, he noticed an erythrematous ring at the location of the bite. Four weeks later, a physician found a large, macular, centrifugally spreading ring. During the next month, it expanded to 35 cm and faded. Over the next 2.5 years, the man experienced recurrent inflammation of a knee. Identify the periods of incubation, prodromal, illness, and decline. What is the etiology? What caused the symptoms? What treatment should have been administered in July? What treatment should be administered two years later?

Section:  23.2

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  5.4

Learning Outcome:  23.10

Global Outcome:  8

3) Worldwide, which disease is the most serious public health threat: malaria, Chagas disease, or brucellosis? Explain why, and provide a plan to reduce the incidence of the disease.

Section:  23.4

Blooms Taxonomy:  Evaluation

ASMcue Outcome:  5.4

Learning Outcome:  23.17

Global Outcome:  8

4) Yellow fever and chikungunya fever are not currently endemic in the United States. Is it possible that they could become established in the future? What factors would play a role? Be sure to include a comparison of the causative agents and vectors in your answer.

Section:  23.3

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  5.4

Learning Outcome:  23.14

Global Outcome:  8

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