Vector-Borne Diseases

Question 1

Common vectors of Lyme disease include all the
following except:
a. I. pacificus
b. I. scapularis
c. I. ricinus
d. D. variabilis

Answer 1

d. D. variabilis

Question 2

The only continent without Lyme disease is:
a. Asia
b. Europe
c. Africa
d. Antarctica

Answer 2

d. Antarctica

Question 3

The primary reservoir in nature for B. burgdorferi is the:
a. White-tailed deer
b. White-footed mouse
c. Lizard
d. Meadowlark

Answer 3

b. White-footed mouse

Question 4

The first B. burgdorferi antigen to elicit an antibody
response is:
a. Outer surface protein A
b. Outer surface protein B
c. Flagellar 41-kDa polypeptide
d. 60-kDa polypeptide

Answer 4

c. Flagellar 41-kDa polypeptide

Question 5

On average, the incidence of infection following an
I. scapularis tick bite in an endemic area is:
a. 1%
b. 3%
c. 5%
d. 10%

Answer 5

b. 3%

Question 6

Erythema migrans:
a. Occurs in all patients
b. Harbors B. burgdorferi in the advancing edge
c. Is easily distinguished from other erythemas
d. Is more common in the winter months

Answer 6

b. Harbors B. burgdorferi in the advancing edge

Question 7

The predominant symptoms of Lyme meningitis are:
a. Severe headache and mild neck stiffness
b. Aseptic meningitis and double vision
c. Cranial nerve palsies and blurred vision
d. Peripheral radiculoneuritis and peripheral
neuropathy

Answer 7

a. Severe headache and mild neck stiffness

Question 8

Cardiac involvement in Lyme disease may include:
a. Murmurs
b. Conduction abnormalities
c. Congestive heart failure
d. Vasculitis

Answer 8

b. Conduction abnormalities

Question 9

Ocular involvement in Lyme disease includes all the
following except:
a. Cranial nerve palsies
b. Conjunctivitis
c. Panophthalmitis with loss of vision
d. Choroiditis with retinal detachment

Answer 9

b. Conjunctivitis

Question 10

Pregnancy in Lyme disease:
a. Does not result in high fetal mortality
b. Has been associated with transplacental
infection
c. Should be terminated because of maternal risk
d. Is not associated with congenital abnormalities

Answer 10

b. Has been associated with transplacental
infection

Question 11

The most useful test for distinguishing between true-
positive and false-positive serologic test results is:
a. Enzyme-linked immunosorbent assay
b. Immunofluorescence assay
c. Polymerase chain reaction
d. T cell assay

Answer 11

c. Polymerase chain reaction

Question 12

Preventive methodsfor Lyme disease include all the following except:
a. Wearing light-colored clothes
b. Tucking pants into socks
c. Applying insect repellent to skin and clothes
d. All of the above

Answer 12

d. All of the above

Question 13

Lyme disease, the most common tickborne disease in the
United States, is a major health hazard for:
a. Dogs
b. Horses and cattle
c. Humans
d. All of the above

Answer 13

d. All of the above

Question 14

Lyme disease is a ________ type of infection.
a. Bacterial
b. Parasitic
c. Viral
d. Fungal

Answer 14

a. Bacterial

Question 15

The first Native American case of what would later be
called Lyme disease occurred in:
a. Connecticut
b. Wisconsin
c. Florida
d. New York

Answer 15

b. Wisconsin

Question 16

Unlike some procedures, the polymerase chain reaction
(PCR) assay can be used to detect Lyme disease–causing
organisms in:
a. Urine
b. Cerebrospinal fluid
c. Synovial fluid
d. Blood

Answer 16

c. Synovial fluid

Question 17

Antigen detection systems in Lyme disease testing screen
for _______ (21) rather than for _______ (22) associated
with the infection. (2 answers)
a. Antibody
b. Microorganisms
c. Antigenic products
d. An infected tick

Answer 17

21. c
22. a

Question 18

23. A patient who has a specific Lyme disease–associated
    manifestation may be treated with:
    a. Vaccination
    b. Interferon
    c. Antibiotic
    d. Analgesic

Answer 18

c. Antibiotic

Question 19

Ehrlichia spp. belong to the same family as the organism
that causes:
a. Lyme disease
b. Rocky Mountain spotted fever
c. Toxoplasmosis
d. Infectious mononucleosis

Answer 19

b. Rocky Mountain spotted fever

Question 20

One of the most common physical findings in adults with
ehrlichiosis is:
a. Hives
b. Fever
c. Erythema migrans
d. Nausea

Answer 20

b. Fever

Question 21

In human granulocytic ehrlichiosis (anaplasmosis), the
diagnosis is confirmed by seroconversion or by a single
serologic titer of _____ in patients with a supporting
history and clinical symptoms.
a. 1:2
b. 1:16
c. 1:80
d. 1:160

Answer 21

c. 1:80

Question 22

In the eastern United States, babesiosis is caused by:
a. B. microti
b. B. canis
c. B. bovis
d. B. equi

Answer 22

a. B. microti

Question 23

Babesiosis is characterized by:
a. Fever
b. Fatigue
c. Hemolytic anemia
d. All of the above

Answer 23

d. All of the above

Question 24

Babesia organisms can be found in:
a. Peripheral blood
b. Sputum
c. Synovial fluid
d. Various exudates

Answer 24

a. Peripheral blood

Question 25

West Nile virus causes:
a. Encephalitis
b. Polio
c. Measles
d. Arthritis

Answer 25

a. Encephalitis

Question 26

West Nile virus is transmitted by:
a. Dogs
b. Cats
c. Rats
d. Mosquitoes

Answer 26

d. Mosquitoes

Question 27

26. Definitive diagnosis of ehrlichiosis requires:
    a. A complete blood count
    b. Detection of the presence of lymphocytopenia
    c. Acute and convalescent serum antibody titers
    d. Direct microscopic observation of inclusions in
    leukocytes

Answer 27

c. Acute and convalescent serum antibody titers