Exam 4 Flashcards
With with virus is this patient infected?
a) polio
b) herpes simplex type 1
c) rabies
d) dengue
c) Rabies
Which lab test should be performed to confirm your diagnosis?
A) RT-PCR on skin or saliva samples
B) Direct Florescent antibody staining of tissue samples
C)Gram Stain
D) both a and b
D) Both A and B
The Urban form of this disease is usually transmitted by which animal(s)?
a) ticks
b) mosquitoes
c) dogs
d) bats
c) Dogs
The sylvatic form of this disease is usually transmitted by which animals?
a) Dogs
b) Squirrels
c) Raccoons
d) Coyotes
e) All except A
E) All Except A
How should the illness be treated?
a) acyclovir
b) valtrex
c) penicillin
d) supportive care
d) Supportive Care
What three viruses (Not prions) can cause chronic neurological disorders?
Measles, JC virus, HIV, HTLV-1
The etiology of this particular case is an unconventional agent that causes a noninflammatory subacute degenerative neurological disorder. What is the name of this etiologic agent? What is the disease in humans called?
Creutzfeldt-Jakob Disease (caused by prions)
A similar disease occurs in sheep. What is it?
Scrapie
What is the disease called in cattle (the formal name)?
Bovine Spongiform Encepholopothy (BSE)- mad cow disease
Name three possible modes if transmission of this agent
Cannibalism, Corneal transplant, eating infected meat
With which organism were the patients infected?
a) strep. pneumoniae
b) histoplasma capsulatum
c) mycobacterium tuberculosis
d) candida albicans
b) Histoplasma Capsulatum
Which of these test may be required to confirm the diagnosis?
a) direct microscopy of lungs and spleen tissue biopsy specimens
b) Mycologic cultures
c) All of these may be necessary
d) antigen detection test
e) serology test
C) all of these may be necessary
How could this illness have been prevented?
a) use of proper PPE
b) vaccination
c) preventing contact with sick people
d) avoiding contaminated food
a) Use of proper PPE
What treatment is indicated for this organism
a) any beta lactam antibiotic
b) a combination of antibiotics
c) itraconazole
d) amoxicillin
c) Itraconazole
Which of these groups be of high risk of infection by this pathogen?
a) Spelunkers (people who explore caves) in the Ohio and Mississippi River valleys
b) Hunters
c) Immunocompromised persons
d) a and c
e) b and c
D) a and c
With which organism were the patients infected?
a) treponema pallidum
b) candida albicans
c) mycobacterium tuberculosis
d) cryptococcus neoformans
d) Cryptococcus Neoformans
Which of these test may be required to confirm the diagnosis?
a) Gram and acid-fast stain of CSF and respiratory specimens
b) India-ink stain of CSF
c) All of these may be necessary
d) Cultures if CSF and blood for bacteria, fungi, and mycobacteria
e) CSF VDRL
C) All may be necessary
What is the most common symptom pf primary lung infection by this organism?
a) asymptomatic
b) fever
c) productive cough
d) arthritis and pain in joints
a) Asymptomatic
What treatment is indicated for this organism?
a) itraconazole
b) amphotericin B alone
c) amphotericin B plus flucytosine (5-FC), followed by life long fluconazole
d) amoxicillin
c) Amphotericin B plus flu cytosine (5-FC), followed by life long fluconazole
How could have this infection been prevented?
a) it could not have been prevented
b) improvement of immune system through antiretroviral therapy (HAART therapy)
c) use of PPE
d) stay away from persons who show symptoms
b) improvement of immune system through antiviral therapy (HAART therapy)
The organism was subsequently shown to form germ tubes. What is the organism?
a) histoplasma capsulatum
b) candida albicans
c) candida tropicalis
d) cryptococcus neoformans
b) Candid Albicans
What other lab test would confirm the diagnosis?
a) Detection of L-proline amino peptidase enzymic activity
b) detection of ß-galactosaminidase enzymatic activity
c) Detection of ß-lactamase enzymatic activity
d) a and b
e) a and c
D) a and b
Is the organism part of the normal flora in humans?
a) yes; of the skin, GI tract,oropharynx, and cervix
b) yes; of the lungs
c) no
d) yes; of the GI tract only
Yes, of the skin, Gi tract, oropharynx, and cervix
How did the treatment with broad spectrum antibiotics predispose this patient to infection with this organism?
May allow growth where it would ordinarily be inhibited by the normal bacterial flora.
The same organism was present in a blood culture of the central venous catheter too. What does this suggest about the portal entry into the patient?
May have become infected via the breath in the skin’s integrity where the central line enters, then spreads to the blood.
The organism was subsequently shown to form germ tubes. What organism is it?
a) pseudomonas aeruginosa
b) aspergillus fumigatus
c) staph. aureus
d) legionella pneumophila
b) Aspergillus fumigatus
What other lab tests would confirm this diagnosis?
a) direct microscopy of sputum
b) cytology staining using KOH/calcifluor
c) all of these may be necessary
d) fungal cultures
e) serum antigen testing for fungal galactomannan
C) All of them may be necessary
What morphology does this organism exhibit?
a) thin hyphae characteristic of a mold
b) germ tubes characteristic of a yeast
c) dimorphic
d) a and b
a) Thin hyphae characteristic of mold
How should this infection be treated?
a) Amphotericin B
b) Voriconazole
c) Itraconazole
d) Any of these would be effective
d) any of these would be effective
How could this infection be prevented?
a) Vaccination
b) HEPA filtration of room air
c) Decrease chemotherapy drugs
d) Administer colony-stimulating-factors like granulocyte-stimulating factor
e) a,b,and c
f) b,c, and d
f) b,c,and d
Which of these agents is likely to cause the type of infection seen in this patient?
a) plasmodium falciparum
b) giardia lamblia
c) entamoeba histolytica
d) salmonella typhi
c) Entamoeba histolytica
How was this illness transmitted?
a) ingestion of intracellular trophozoites from contaminated food or water
b) ingestion of mature cysts form contaminated food or water
c) consumption of clean water
d) all of these are possible
b) Ingestion of mature cysts from contaminated food or water
Which organ in the body does this organism colonize?
a) stomach
b) heart
c) kidneys
d) large intestines
d) Large intestine
This organism can also cause accesses at which secondary sites of the body?
a) liver and lungs
b) heart and stomach
c) heart and kidneys
d) none- this organism is unable to cause secondary abscesses
a) Liver and the Lungs
How should this illness be treated?
a) iodoquinol alone
b) diloxanide furoate alone
c) paramymycin alone
d) metronidazole then iodoquinol, diloxanide furoate, or paramymycin
d) Metronidazole then idoquinol, diloxanide furoate, or paramycin
What is the organism causing his illness?
a) giardia lamblia
b) campylobacter jejuni
c) salmonella enterocolitica
d) norwalk virus
a) Guardia Lamblia
What laboratory test would confirm your diagnosis?
a) serology to detect antibodies against the pathogen
b) giemsa stain of cerebrospinal fluid
c) antigen detection in stool
d) PCR to detect viral nucleic acid
c) Antigen detection in the stool
How does this disease spread?
a) water contaminated with fecal material
b) Bite of an infected rodent
c) Inhalation of rodent urine
d) hand-to-mouth transfer of cysts among infants and young children
e) a and d
e) a and d
How can infection be prevented?
a) Purify water by boiling or filtration to remove cysts
b) vaccination
c) Regular hand washing in day-care setting
d) a and c
d) a and c
How should this illness be treated?
a) penicillin
b) vancomycin
c) amphotericin B and 5-FC, then fluconazole
d) metronidazole for 7 days
d) Metronidazole for 7 days
What is the organism causing his illness?
a) plasmodium falciparum
b) leishmania major
c) ebola
d) salmonella typhi
a) Plasmodium Falciparum
What factors put this patient at risk for infection by this organism?
a) travel to an area in which the organism is endemic
b) Failure to take appropriate prophylaxis
c) Lack of immunity to this organism since he lives in an area where it isn’t an endemic
d) spending time in real areas, which makes exposure to infected vectors more likely
e) All of these are risk factors
e) All of these are risk factors
How is this disease spread?
a) bite of an infected mosquito
b) bite of an infected rodent
c) ingestion of contaminated water
d) person to person via aerosolized droplets
a) Bite of an infected mosquito
How can this infection be prevented?
a) Pre-exposure chemoprophylaxis, e.g., with mefloquine or chloroquine
b) Vaccination
c) It can’t be prevented
d) Use of insecticides containing N,N-diethyl-m-toluamide (DEET)
e) a and d
f) a and b
e) a and d
The number of cases of infection with this organism is increasing in the US.Why is this occurring?
d) All of these are reasons for the increasing number of malaria cases in the U.S.
( JUST KNOW THAT IT IS ALL OF THE OPTIONS)
What is the organism causing his illness?
a) leishmania major
b) giardia lamblia
c) trypanosoma cruzi
d) toxoplasma gondii
a) Leishmania Major
Which form of this disease is the patient exhibiting?
a) cutaneous
b) mucocutaneous
c) visceral
d) post kala azar dermal
a) Cutaneous
How is this disease spread?
a) bite of an infected sand fly
b) bite of an infected rodent
c) inhalation of rodent urine
d) in cat feces
a) Bite of an infected sand fly
How can infection be prevented?
a) cover exposed areas of skin, since the vector can’t bite through clothing
b) vaccination
c) it can’t be prevented
d) use mosquito netting
a) Cover exposed areas of the skin, since the vector can’t bite through clothing
How is this illness typically diagnosed?
a) Lab test to distinguish from leprosy, tertiary syphilis, or dimorphic fungal infections
b) Giemsa-stained biopsy of a lesion
c) Culture on enrighed triple N medium
d) PCR
e) All of these are typically used
e) all of these are typically used
Which nematodes commonly caused gastrointestinal infections in humans?
a) Necator Americanus
b) Enterobius Vermicularis
c) Trichuris trichina
d) Ascaris lumbricoides
e) All of these are common, medically important intestinal nematodes
e) all of these are common, medically important intestinal nematodes
How is this illness typically diagnosed?
a) microscopic identification of eggs in the stool
b) gram stain of stool samples to detect organisms
c) dark field microscopy of blood smear
d) indirect immunofluorescence of blood smear
a) Microscopic identification of eggs in stool
How is this illness transmitted?
a) ingestion of infective egs from contaminated soil
b) ingestion of the adult organism from contaminated food
c) ingestion of infective cysts form contaminated water
d) ingestion of trophozoites from contaminated water
a) Ingestion of ineffective eggs from contaminated soil.
Which of the following stages is not involved in the pathogenesis of this organism?
a) Larvae hatch and invade intestinal mucosa
b) Larvae are carried by good to the lungs
c) Larvae mature and penetrate the walls of the alveoli
d) Larvae ascend bronchial tree and are swallowed
e) All of these stages occur with this organism
e) All of these stages occur with this organism
What determines the severity of disease with this organism?
a) the number of eggs ingested ( worm burden)
b) the extent to which the worm replicates in the host
c) the severity of the diarrhea the worm causes
d) the extent to which it migrates to the tear ducts
a) the number of eggs ingested (worm burden)
How should this infection be treated?
a) metronidazole
b) supportive care only
c) amoxicillin
d) mebendazole
a) metronidazole
Which TWO of these viruses (NOT subviral particles) can cause CHRONIC neurologic disorders?
a) Polio and prions
b) measles and HIV
c) HIV and Ebola
d) measles and prions
b) measles and HIV
The etiology of this particular case is an unconventional agent that causes a noninflammatory subacute degenerative neurologic disorder. What is the disease in humans called?
a) scrapie
b) chronic wasting disease
c) Bovine spongiform encephalopathy
d) creutzfeldt-jakob disease
e) ovine spongiform encephalopathy
d) creutzfeldt-jakob disease
What is the disease called in cattle?
a) scrapie
b) chronic wasting disease
c) bovine spongiform encephalopathy
d) ovine spongiform encephalopathy
e) creutzfeldt-jakob disease
c) bovine spongiform encephalopathy
What is the nature of the infectious agent?
a) it consists of a structurally misformed cellular protein
b) it contains double-stranded DNA and protein
c) it consists of naked nucleic acid
d) it consists of a normal cellular protein
a) it consists of a structurally misformed cellular protein
Which of the following is NOT a possible mode of transmission of this agent?
a) cannibalism
b) brain tissue grafts
c) pituitary derived human growth hormone from infected cadaver tissue
d) the bite of an infected arthropod
e) consumption of contaminated meat
d) the bite of an infected arthropod
With what virus was this patient likely infected?
a) measles virus
b) simian immunodeficiency virus
c) human immunodeficiency virus
d) herpes simplex type 1
c) human immunodeficiency virus
What specific cell types are most commonly infected with this virus?
a) liver cells
b) T cells
c) neurons
d) B cells
b) T cells (human immunodeficiency virus)
What cell surface receptor is the primary binding site of this virus?
a) sialic acid
b) CD4
c) CD8
d) ICAM-1
b) CD4 (human immunodeficiency virus)
What serologic testing is most frequently performed to make this diagnosis?
a) Southern blot
b) ELISA
c) flow cytometry
d) northern blot
b) ELISA (human immunodeficiency virus)
What is the likely cause of the white plaque?
a) Secondary infection with HSV-1 (Human herpies virus)
b) Secondary infection with Candida albicans
c) Secondary infection with Aspergillus fumigatus
d) Secondary infection with HHSV-8 (Human herpies virus)
b) Secondary infection with Candida albicans (human immunodeficiency virus)
Which of these agents is likely to cause the type of infection seen in this patient?
a) Giardia lamblia
b) Entamoeba histolytica
c) Salmonella typhi
d) Plasmodium falciparum
b) Entamoeba histolytica
How is this illness transmitted?
a) ingestion of intracellular trophozoites from contaminated food or water
b) consumption of clean water
c) all of these are possible
d) ingestion of mature cysts from contaminated food or water
d) ingestion of mature cysts from contaminated food or water (Entamoeba histolytica)
Which organ in the body does this organism colonize?
a) heart
b) kidney
c) large intestines
d) stomach
c) large intestines (Entamoeba histolytica)
This organism can also cause abscesses at which secondary sites in the body?
a) heart, stomach, and lungs
b) liver, lungs, and brain
c) heart, kidneys, and brain
d) none- this organism is unable to cause secondary abscesses
b) liver, lungs, and brain (Entamoeba histolytica)
How should this illness be treated?
a) diloxanide furoate alone
b) paramymycin alone
c) metronidazole then iodoquinol, diloxanide furoate, or paramymycin
d) iodoquinol alone
c) metronidazole then iodoquinol, diloxanide furoate, or paramymycin
(Entamoeba histolytica)
What is the organism causing his illness?
a) Ebola virus
b) Staphyloccus aureus
c) Plasmodium falciparum
d) Leishmania major
c) Plasmodium falciparum
How can you distinguish between the different species of this organism?
a) by the frequency with which the fever spikes
b) by DNA sequencing
c) by detection of species specific antigens in the blood
d) by detection of species specific antibodies in the blood
a) by the frequency with which the fever spikes (Plasmodium falciparum)
What factors put this patient at risk for infection by this organism?
a) all of these are risk factors
b) failure to take appropriate prophylaxis
c) lack of immunity to this organism since he lives in an area where it isn’t endemic
d) spending time in rural areas, which makes exposure to infected vector more likely
e) travel to an area in which the organism is endemic
a) all of these are risk factors (Plasmodium falciparum)
How is this disease spread?
a) ingestion of contaminated water
b) bite of an infected rodent
c) bite of an infected anopheles mosquito
d) person to person via aerosolized droplets
c) bite of an infected anopheles mosquito (Plasmodium falciparum)
How can infection be prevented?
a) vaccination
b) filtering or boiling of water
c) it can’t be prevented
d) pre-exposure chemoprophylaxis, eg with mefloquine or chloroquine
d) pre-exposure chemoprophylaxis, eg with mefloquine or chloroquine (Plasmodium falciparum)
The organism was subsequently shown to form germ tunes. What is the organism?
a) Legionella pneumophila
b) Pseudomonas aeruginosa
c) Aspergillus fumigatus
d) Staphylococcus aureus
c) Aspergillus fumigatus
What other lab tests would confirm this diagnosis?
a) serum antigen testing for fungal glycoproteins
b) direct microscopy of sputum
c) cytology staining using KOH/calcifluor
d) All of these may be necessary
e) fungal cultures
d) all of these may be necessary (Aspergillus fumigatus)
What morphology does this organism exhibit?
a) dimorphic
b) thin hyphae characteristic of a mold
c) germ tunes characteristic of a yeast
d) b and c
b) thin hyphae characteristic of a mold (Aspergillus fumigatus)
How should this infection be treated?
a) any of these would be effective
b) amphotericin B
c) Voriconazole
d) Itraconazole
a) any of these would be effective (Aspergillus fumigatus)
How could this infection be prevented?
a) use of insect repellants containing DEET
b) vaccination
c) decrease chemotherapy drugs
d) administer colony-stimulating factors like granulocyte-stimulating factor ( GCSF)
e) c and d
e) c and d (Aspergillus fumigatus)
What is the organism causing this illness?
a) salmonella enterocolitica
b) norwalk virus
c) giardia lamblia
d) campylobacter jejuni
c) giardia lamblia
What laboratory tests would confirm your diagnosis?
a) antigen detection in stool
b) PCR to detect viral nucleic acid
c) serology to detect antibodies against the pathogen
d) giemsa stain of cerebrospinal fluid (CSF)
a) antigen detection in stool (giardia lamblia)
How is this disease spread?
a) water contaminated with fecal material
b) hand to mouth transfer of cysts among infacnts and young children
c) inhalation of rodent urine
d) bite of an infected rodent
e) a and b
e) a and b (giardia lamblia)
How can this infection be prevented?
a) eat only packaged foods
b) vaccination
c) use insect repellants
d) purify water by boiling or filtration to remove cysts
d) purify water by boiling or filtration to remove cysts (giardia lamblia)
How should this illness be treated?
a) Amphotericin B and 5-FC, then fluconazole
b) Metronidazole
c) penicillin
d) vancomycin
b) metronidazole (giardia lamblia)
Which parasite was probably found in this patient ( i.e., which looks most like an earthworm)?
a) roundworm (ascaris lumbricoides)
b) hookworm (necator americanus)
c) pinworm (enterobius vermicularis)
d) whipworm ( trichuris trichiura)
a) roundworm (ascaris lumbricoides)
What determines the severity of disease with this organism?
a) the extent to which it migrates to the tear ducts
b) the number of eggs ingested (worm burden)
c) the extent to which the worm replicates int he host
d) the severity of the diarrhea the worm causes
b) the number of eggs ingested (worm burden)
[roundworm (ascaris lumbricoides)]
Which of the following IS NOT part of the life cycle of this nematode?
a) inhaled eggs hatch int he lungs
b) ingested eggs hatch in the intestines
c) larvae travel via bloodstream to lungs
d) larvae develop in alveoli, travel up to trachea, are swallowed and returned to small intestines
e) on reaching adulthood, females la huge numbers of eggs that are released in the stool
a) inhaled eggs hatch in the lungs
[roundworm (ascaris lumbricoides)]
How should this infection be treated?
a) metronidazole
b) supportive care only
c) amoxicillin
d) mebendazole
a) metronidazole
[roundworm (ascaris lumbricoides)]
How is this illness typically diagnosed?
a) indirect immunofluorescence of blood smear
b) microscopic identification of eggs int he stool
c) gram stain of stool samples to detect organisms
d) dark field microscopy of blood smear
b) microscopic identification of eggs in the stool
[roundworm (ascaris lumbricoides)]
The organism was subsequently shown to form germ tubes. What is the organism?
a) candida albicans
b) cryptococcus neoformans
c) histoplasma capsulatum
d) toxoplasma gondii
a) candida albicans
Is the organism part of the normal flora in humans?
a) yes, of the GI tract only
b) Yes, of the skin, GI tract, oropharynx, and cervix
c) yes, of the lungs
d) no
b) yes, of the skin, GI tract, oropharynx, and cervix (candida albicans)
How did the treatment with broad-spectrum antibiotics predispose this patient to infection with this organism?
a) the antibiotics select for resistant versions fo this organism
b) the antibiotics were contaminated with tis organism
c) the antibiotics killed off his normal gut flora, which help control this organism
d) the antibiotics had nothing to do with this infection
c) the antibiotics killed off his normal gut flora, which help control this organism (candida albicans)
How should this illness be treated?
a) amoxicillin
b) doxycycline
c) medendazole
d) fluconazole
d) fluconazole (candida albicans)
The same organism was present in the blood and in a culture of the central venous catheter tip. What does this suggest about the prtal of entry into the patient?
a) the organism must have entered the bloodstream and contaminated the catheter
b) the organism must have entered the skin where it was breached by the central line, then entered the bloodstream
c) it is a blood borne pathogen that probably came from a mosquito bite- and the catheter wasnt contaminated at all
d) the catheter became contaminated before it was inserted into the patient
b) the organism must have entered the skin where it was breached by the central line, then entered the bloodstream
(candida albicans)
What is the organism causing his illness?
a) trypanosoma cruzi
b) toxoplasma gondii
c) leishmania major
d) giardia lamblia
c) Leishmania major
Which form of this disease is te patient exhibiting?
a) visceral
b) mucocutaneous
c) transdermal
d) cutaneous
d) cutaneous (leishmania major)
How is disease spread?
a) bite of an infected sand fly
b) in cat feces
c) bite of an infected rodent
d) inhalation of rodent urine
a) bite of an infected sand fly (leishmania major)
How can infection be prevented?
a) use mosquito netting
b) cover exposed areas of skin, since the vector can’t bite through clothing
c) vaccination
d) it can’t be prevented
b) cover exposed areas of skin, since the vector can’t bite through clothing (leishmania major)
How is this illness typically diagnosed?
a) all of these are typically used
b) lab tests to distinguish from leprosy, tertiary syphilis, or dimorphic fungal infections
c) giemsa-stained biopsy of a lesion
d) culture on enriched triple N medium
e) PCR
a) all of these are typically used (leishmania major)
With which virus is this patient infected?
a) polio
b) dengue
c) rabies
d) herpies simplex type 1
c) rabies
Which of these lab tests WOULD NOT confirm your diagnosis?
a) direct fluorescent antibody staining of tissue samples
b) gram stain
c) RT-PCR on skin samples
d) RT-PCR on saliva samples
b) gram stain (rabies)
How should this illness be treated?
a) valtrex
b) penicillin
c) acyclovir
d) supportive care
d) supportive care (rabies)
What is the eventual outcome of untreated human infections with this virus?
a) it is almost never fatal
b) complete recovery from the acute infection but long term pain is common
c) complete recovery from the acute infection without any long term effects
d) complete recovery from the acute infection but often chronic infections remain
e) it is almost always fatal
e) it is almost always fatal (rabies)
In cities, which of these animals usually transmits this virus?
a) ticks
b) mosquitoes
c) dogs
d) bats
c) dogs (rabies)
