Exam 5 practice questions

Question 1

1. 19 yo male develops fever, headaches and confusion after returning home from a week long hiking trip where he swam in several rivers and lakes. CSF analysis reveals gram stain negative for bacteria or yeast and low glucose concentration. While looking at a wet mount you see large motile cells similar to WBCs. Which organism most likely produced this form of primary acute encephalitis?

Answer 1

Naegleria fowleri

Question 2

How is this infection treated?

Answer 2

Amphotericin B

Question 3

What are risus sardonicus and opisthotonos associated with?

Answer 3

Tetanus

Question 4

What is true about the PrPc genes from fatal sporadic CJD cases.

Answer 4

Contains amino acids that resist degradation

Question 5

What is true about HSV-1 keratitis?

Answer 5

Leading cause of blindness in developed countries.

Question 6

What should be given to a 21 yo female who steps on a nail that had four DPT vaccinations by age one and a booster at age 6?

Answer 6

Should be given toxoid boster

Question 7

. Listeria infections are eradicated by our immune system by what mechanism?

Answer 7

An intracellular pathogen, so T-cell mediated?

Question 8

How are infectious CJD prions thought to be transmitted?

Answer 8

Direct inoculation. Corneal trasplants, pituitary growth hormone, unsterilized neuro equipment

Question 9

Which form of viral encephalitis uses mosquitos as its vector?

Answer 9

Arboviruses?

Question 10

7 yo male steps on glass at a park. Pt is up to date on all his vaccinations but he has non detectable antibody titers to diphtheria, tetanus and pertussis. How would this patient be treated?

Answer 10

Give passive immunization with human tetanus immune globulin

Question 11

. The West Nile virus has an antigenic cross reactivity with which other viral infection.

Answer 11

St. Louis

Question 12

33 yo male presents with loss of peripheral vision and large red and white retinal lesions. What else must also be true about this Pt.

Answer 12

THIS IS CMV Retinitis

Question 13

A vaginal gram stain and culture reveals gram + cocci, catalase negative and an area of hemolysis when in the presence Staph aureas. What is the microbe? Picture included on test

Answer 13

agalactiae

Question 14

After living on home canned food while his parents when to Europe. Mom and dad come home to find Jimmy disoriented with dry oral mucosa, ptosis, slow pupillary reflexes and no gag reflex. Which microbe is most likely?

Answer 14

Clostridium botulinum

Question 15

This virus produces paralysis similar to polio and has been transmitted via blood transfusions

Answer 15

West Nile Virus

Question 16

Which organism has the ability to sporulate?

Answer 16

Clostridium species

Question 17

What would you expect to see in a lumbar puncture from a Pt with viral encephalitis?

Answer 17

Lumbar puncture = CSF

Question 18

While camping in the Rockies in Mid July, Robby develops fever, chills and headache x 2 days which later subsides then ultimately returns 2 days later. Pt reports multiple different insect bites including finding two ticks on him. Pt denies rash. What is true regarding the diagnosis?

Answer 18

Got an arbovirus infection (tick) and can’t donate blood for 6 months

Question 19

This form of ear infection involves rapid progression to bone and neuronal structures with discharge from auditory canal.

Answer 19

Pseudomonas aeruginosa

Question 20

What is the proper treatment for botulism cases?

Answer 20

Antitoxin

Question 21

What is true regarding rabies transmission?

Answer 21

Doesn’t have to be a bite, just need salvia to contact mucus???

Question 22

. Which organism is most likely to cause meningitis in elderly patients?

Answer 22

Strep Pneumoniae

Question 23

When performing a MAC-ELISA test for an encephalitis case, how would the results from a CSF sample differ from a serum sample.

Answer 23

IgM does not cross blood-brain barrier, so CSF positivity most strongly suggests CNS infection

Question 24

This form of meningitis is seen in at-risk patients who have eaten contaminated food.

Answer 24

Listeria

Question 25

. In what way is Creutzfeldt-Jacob disease and mad cow disease thought to be related?

Answer 25

Retrospective studies noted the time and location relationship between them

Question 26

. What happens to the antibody titers as leprosy progresses?

Answer 26

Switch from CMI-->AMI

Question 27

Which of the following is a typical route of transmission for toxoplasmosis?

Answer 27

Foodborne (zoitocysts

Question 28

What effect did providing clean public drinking water have on the emergence of polio virus epidemics?

Answer 28

Clean water-->no polio-->get polio later in life, more deadly

Question 29

Why is the inactivated polio virus vaccine use for immunizations?

Answer 29

No chance for back mutation causing polio from a vaccine

Question 30

What is the most common cause of neonatal meningitis?

Answer 30

S. agalactiae

Question 31

. Which virus has the highest encephalitis fatality rate but the lowest annual infections?

Answer 31

EEE

Question 32

Often this organism requires years of incubation to develop disease?

Answer 32

Mycobacterium leprae

Question 33

Which organism produces childhood meningitis and can be prevented with a conjugate vaccine?

Answer 33

H Influenz

Question 34

Which form of encephalitis is more common in elderly Pts vs young children?

Answer 34

West Nile

Question 35

What is a complication seen in external auditory canal infections with Pseudomonas?

Answer 35

cns spread?

Question 36

23 yr old medical student who had 4 injections of diphtheria, pertussis, and tetanus(DPT) in her first year of life and a booster at age 5, but who has no subsequent tetanus immunizations, is bitten by a mouse while doing an experiment. She should be given:

Answer 36

Tetanus toxoid, which will actively immunize her.

Question 37

Why is finding staphylococcus epidermidis not a problem with an eye culture?

Answer 37

Normal flora of eye

Question 38

What is the primary cause of orbital cellulitis?

Answer 38

Sinsitis infection (staph and strep)

Question 39

A hordeolum is:

Answer 39

Painful and goes away quickly

Question 40

trachoma can be transmitted via:

Answer 40

Secretions, mechanical vectors, and fomites

Question 41

Ophthalmia neonatorum due to neisseria gonorrhoeae is:

Answer 41

Present 24-48 hrs after birth

Question 42

A healthy person who has poor vision even with his contacts and eye pain is least likely to have an infection due to:

Answer 42

Fusarium solani

Question 43

Klebsiella can cause

Answer 43

Endophthalmitis

Question 44

Retinitis and Conjunctivitis can both be caused by

Answer 44

HSV and Adenovirus

Question 45

Enteroviruses and Polio virus infect

Answer 45

Via intestinal infection

Question 46

PML and HSV-1 is due to a

Answer 46

Reactivation of a latent virus

Question 47

LCMV is associated with

Answer 47

Mouse infestation in housing

Question 48

Measure to reduce viral encephalitis via arboviruses is being done via

Answer 48

Eradication/control of arthropod vectors

Question 49

Kid playing in the daytime is likely to be infected via

Answer 49

California Encephalitis - Lacrosse

Question 50

This arbovirus has the widest range and most cases

Answer 50

WNV

Question 51

When looking for rabies, this is diagnostic

Answer 51

Negri body inclusions

Question 52

How do you treat a rabies exposure?

Answer 52

Administer both HRIG and vaccine, Giving ½ HRIG into wound and rest in gluteal, and vaccine into deltoid (4 shots over 3-4 wks)

Question 53

HIV encephalitis is due to

Answer 53

Indirect destruction of nonneuronal (glial) cells

Question 54

Person infected from visit to Pacific Norwest, Canavanine glycine bromothymol blue medium shows blue:

Answer 54

C. gatti infection

Question 55

This organism has spiked pseudopodia

Answer 55

Acanthamoeba

Question 56

Legionella pneumophila can replicate in this parasite and increase its virulence

Answer 56

B mandrillaris

Question 57

This virulence factor disrupts the phagolysosome membrane

Answer 57

Listeriolysin O

Question 58

Person has meningitis after a renal transplant

Answer 58

Listeriosis caused it

Question 59

What virulence factor causes a loss of cilia, inflammation and sloughing of damaged epithelial cells

Answer 59

ANTIGEN STILL PRESENT

Question 60

Which organism is bile soluble?

Answer 60

Strep PNeumoniae

Question 61

Military recruit gets meningititis, cause?

Answer 61

NEisseria meningitidis

Question 62

Which form of leprosy gets Erythema nodosum (painful and erthematous nodules?)

Answer 62

BL or LL

Question 63

Which of these is least likely to be helpful in determing leprosy?

Answer 63

A positive Lepromin test

Question 64

Clostridium are

Answer 64

Obligate anaerobes that produce endospores

Question 65

Botulinum works at level of neuromuscular junction

Answer 65

Tetanus at CNS (DIFFERENT LOCATIONS)