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74 Cards in this Set
- Front
- Back
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routes into the cns
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blood brain barrier
infections of the face above the mouth travel up nerve bundles bones-sinus infection skull fractures/otorrhea or rhinorrhea penetrating injuries |
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types of infections of the cns
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-meningitis
-encephalitis -localized brain abscess |
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types of meningitis
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-acute bacterial meningitis
-acute viral meningitis -chronic meningitis |
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acute bacterial meningitis
common symptoms 7 |
-mild cold
-severe throbbing headache, nausea and vomiting stiffness in neck and back |
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acute bacterial meningitis
characteristics of csf |
-pressure is increased
-csf is cloudy, contains pus -increased protein -decreased glucose -neutrophils present -bacteria can be cultured and found on staining the csf |
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acm meningococcal meningitis
symptoms |
"neisseria meningitides"
-mild cold-> severe headache/fever-> deafness/coma -petechial rash-purplish spots, hemorrpages -shock-death within 24 hrs |
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abm meningococcal meningitis
pathogenesis |
-inflamation-pus and clots, push brain against skull, damage to auditory/optic nerves = motor nerve paralysis
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abm meningococcal meningitis
pathogenesis |
-endotoxin-shock, rash
-kerning's sign |
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abm meningococcal meningitis
epidemiology |
-occurs in infants 6-11 months
-occurs often in military and colleges -human only source of infection |
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abm meningococcal meningitis
prevention and treatment |
-vaccine is available
-not given to children less than 11 yrs old -Rifampin is given to exposed people |
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which of the following causes chronic granulomatous meningitis?
-filobacidella neoformans -mycobacterium tuberculosis -treponema pallidum -all of the above are causes |
-all of the above are causes
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which is the best way to prevent meningococcal meningitis in individuals?
-vaccinate them against neisseria meningitis -have them return to their usual activities, but seek medical evaluation if symptom of meningitis occur. withdraw a sample of spinal fluid and begin antibacterial treatment if cell count is high and glucose is low -treat them with antibiotic rifampin |
-treat them with antibiotic rifampin
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which of the following is a method by which micro-organisms can gain access to the cns?
-through the blood-brain barrier via the blood supply -by traveling up nerve fibers (axoplasmic route) -by penetrating the bone -all of the above are methods |
-all the above are methods
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which percentage of septicemia cases are caused by gram (-) bacteria?
-5% -15% -30% -50% |
-30%
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macrophages play a key role in septic shock associated with septicemia?
true/false |
true
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a patient who has a history of recent head trauma describes having larger than usual volumes of fluid draining from their nose. on examination it is noted the fluid is clear and watery and different from usual nasal mucus. what is the most likely cause of the problem in this patient?
-this describes fluid from a subarachnoid hemorrhage -this describes catarrhal discharge from a cold -this describes rhinorrhea from a fracture across the floor of the skull -this describes otorrhea from a fracture across the floor of the skull |
this describes rhinorrhea from a fracture across the floor of the skull
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primaquine is used to treat which stage of plasmodium?
-merozoites -gametocytes -sporozoites -hypnozoites |
hypnozoites
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which one false statement about rabies
-it is wide spread in wildlife -vaccines are available to protect humans and domestic animals -hydrophobia is a characteristic of symptom -animals that do not bite do not get the disease -the incubation period is often a month or more |
animals that do not bite do not get the disease
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in the malaria life cycle, which from of the protozoan comes out of cysts that rupture in the mosquito intestine?
-sporozoites -merozoites -gametocytes -zygotes |
sporozoites
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what is a direct consequence of rbc's bursting in malaria?
-heart failure -stroke -anemia -overworked immune system |
anemia
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which of the following statements about african sleeping sickness is true?
-it is transmitted by the bite of tsetse fly -it is caused by a flagellated protozoa -the symptoms are tender nodule at the site, fever, enlarged lymph nodes and cns involvement -preventative measures are protective clothing, insecticides and clearing brush -all of the above |
all of the above
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an 80 year old individual was brought to emergency department, he had 103 fever, vomiting and stiff neck. ER doctor did spinal tap and sent csf to the lab for testing. following is the csf finding. cloudy, increase protein, low glucose level, neutrophil count high. which of the following is the causative agent for this disease?
-hsv 1 and 2 -coxsackie virus -neisseria meningitis -streptococcus pneumonia -all of the above |
streptococcus pneumonia
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which of the following statements is true?
-the cheif source of cns infections is by bacteria invading from the bloodstream. -harmful agents are usually prevented from entering the brain because of the blood-brain barrier. -pathogens can gain entrance to the cns via peripheral nerves, the blood and from the sinuses of the skull -the normal flora of the cns protects it from most pathogens -a,b and c are true |
a,b and c are true
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diseases of the blood vascular system are systemic diseases?
true/false |
true
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which of the following is the causative agent for acute bacterial endocarditis?
-viridans streptoccocci -staphylococcus epidermidis -staphylococcus aureus -streptococcus pneumoniae |
staphylococcus aureus
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pneumonia occurs in what percentage of tularemia cases?
-25-30% -10-15% -1-5% -20-25% |
10-15%
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which species of brucella can infect goats and humans?
-abortus -melitensis -canis -suis |
melitensis
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plague is not endemic to which continetn?
-south america -north america -europe -australia |
australia
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most cases of malaria in the u.s. are caused by?
-plasmodium falciparum -plasmodium vivax -plasmodium malariae -plasmodium ovale |
plasmodium vivax
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match the following organisms with their diseases.
-haemophilus influenzae -crytococcus neoformans -trypanosoma cruzi -coxsackie mumps -arbovirus *viral meningitis *epidemic viral encephalitis *bacterial meningitis |
*viral meningitis-coxsackie and mumphs
*epidemic viral enephalitis-arbovirus *bacterial meningitis-haemophilus influenza |
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which stage of life cycle of plasmodium is found only in the liver?
-merozoites -gametocytes -hypnozoites -sporozoites |
hypnozoites
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you have a patient who presents in your office 3 days post-op. he presents with a high fever, elevated pulse and respirations. he complains of fatigue with an increased level of anxiety as well as decreased urinary output. based on the presentation of this patient and his history you should suspect?
-septicemia -sbe -infectious mono -dengue fever |
septicemia
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which of the following conditions are common in immunocompromized patients?
-progressive multifocal leukoencephalopathy -cryptococcal meningoencephalitis -listeria monocytogenes meningitis -all of the above |
progressive multifocal leukoencephalopathy
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which of the following is the most likely cause of acute bacterial meningitis in a new born?
-streptococcus agalactiae -hemophilus influenzae -streptococcus pneumonnia -neisseria meningitidis -all of the above |
streptococcus agalactiae
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which of the following is a predisposing factor for subacute bacterial endocarditis?
-shingles -dental caries -rheumatic fever -mumps |
dental caries
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which of the following is not a problem (characteristic) associated with the formation of a vegetation (biofilm) on a heart valve?
-it protects organisms from phagocytes -it allows bacteria to continuously wash off -it protects organisms from antibiotic treatment -it strengthens the blood vessels it can contribute to abscesses |
it allows bacteria to continuously wash off
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which of these statements concerning the causative agent of listeriosis is false?
-it can cause meningitis during first month of life. -it is a gram-positive rod that can grow in refrigerated food. -it is usually transmitted by respiratory route. -infection commonly results in bacteremia. -it is widespread in natural waters and vegetation |
it can cause meningitis during first month of life.
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which of the following statements about poliomyelitis is false?
-motor and sensory nerves are usually involved -it can be caused by any of the three specific enteroviruses -only a small fraction of those infected will develop the disease -the disease is transmitted via the fecal-oral route -a postpolio syndrome can develop years after recovery from the original illness |
motor and sensory nerves are usually involved
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which of the following statement about arboviral encephalitis is false?
-it is likely to occur in epidemics -mosquitoes can be an important vector -epilepsy, paralysis and thinking difficulties are among the possible sequels to the disease -in the u.s. the disease is primarily a zoonsis involving cattle -usually caused by one of the arboviruses, lacrosse, st. luis, west nile, and eastern equine |
in the u.s.
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which of the following is an example of a sporadic viral encephalitis that can occur in the newborn by infection from the mothers birth canal?
-measles enephalitis -mumps encephalitis -herpes simplex encephalitis -variccella-zoster encephalitis |
herpes simplex encephalitis
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which statement concerning cryptococcal meningoencephalitis is true?
-it is caused by an encapsulated yeast -it is a disease of pigeon transmissible to humans -person to person transmission commonly occurs -typically it attacks the meninges but spares the brain -cell-mediated immunity is of little importance in the body's struggle against the disease |
it is caused by an encapsulated yeast
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which plasmid is essential for the spread of yersinia pestis to the lymph nodes?
-pla -fra -yops -none of the above |
pla
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which of the following strategies is the best way to prevent bovine spongiform?
-avoid giving cattle food containing animal parts -heat all food before feeding to cattle -ensure that cattle do not share drinking water -give cows only organic grown feed -avoid feeding cattle calcium in the feed |
avoid giving cattle food containing animal parts
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african sleeping sickness is caused by which of the following organisms?
-trypanosoma brucei -naegleria fowleri -cryptococcus neoformans -giardia lamblia -tsetse fly |
trypanosoma brucei
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virus may be present in saliva up to how long following an infection of mono?
-6 weeks -3 months -6 months -18 months |
18 months
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what percentage of people who have had infectious mononucleosis are carriers?
-5% -10% -20% -40% |
20%
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the vector for yellow fever is the anopheles mosquito?
true/false? |
false
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which of the following statements about the spongiform encephalopathies is false?
-they are named because of the characteristic spongy appearance of the brain due to loss of tissue -the disease is caused by a prion -the incubation period is very long, usually years to decades -prions can be destroyed by heat, ultraviolet light and there is an inflammatory response to infection -human to human transmission has occurred from corneal transplants and contaminated surgical instruments |
prions can be destroyed by heat, ultraviolet light and there is an inflammatory response to infection
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what is the incubation period following being bitten by an infected flea?
-2-10 days -30-6 days -1-6 days 3-7 days |
1-6 days
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which genus is responsible for causing tularemia?
-yersinia -flavivirus -plasmodium -francisella |
francisella
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which of the following acts with tnf to cause fever and release leukocytes from bone marrow in septicemia?
-interlukin 1 -fra -yops -complement |
interleukin 1
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gram (-) septicemia is usually nosocomically aquired infection?
true/false? |
true
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all three zoonoses disease discussed in class are common in humans in the u.s.
true/false? |
true
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dengue fever is a single stranded rna virus
true/false? |
true
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college students planning to stay in group housing should consider vaccinations against which of the following diseases?
-listeriosis -meningococcal (neisseria meningitides) meningitis -hansen's disease -viral encephalitis -rabies |
listeriosis
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which of the following statements about leprosy is true?
-it is also called hansen's disease -it is caused by mycobacterium leprae -the earliest dettectable signs of infection are in small nerves of the skin -the source of the bacteria is mainly the nasal secretions from someone suffering from leprosy -all of the above |
all of the above
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which of the following is not true about botulism?
-it is caused by clostridium botulinum -early symptoms include blurreed vision, nausea, and vomiting -the bacteria produce endospores that can persist and grow in food even if boiled -death is usually due to paralysis from generalized muscle contractions. -disease is caused by a neurotoxin |
death is usually due to paralysis from generalized muscle contraction.
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SaBE- What organisms cause this disease?
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usually normal flora of the mouth and skin.
-viridans streptococci -staphylococcus epidermidis |
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SaBE-what are the symptoms of the following disease?
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general symptoms-
-marked fatigue -slight fever, lower than ABE=100-101 -lose energy gradually over weeks to months |
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SaBE-epidemiology
-cases with viridans streptococci -cases with staphylococcus epidermidis |
-viridans- antibiotics for people with valve problems before dental work.
-staphylococcus epidermidis- IV drug abusers -hospitalized people with plastic IV catheters in place for a long time -people with artificial heart valves |
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SaBE- pathogenesis
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-dental procedures.
-abnormal valve forms a clot, clot-growth-clot-growth=protects it from antibiotics -can burrow in heart valve, can lodge in eyes,skin,organs |
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SaBE- prevention and treatment
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-no proven method
-antibiotics before dental procedures -aseptically inserting catheters -moving IV catheters every few days -take out catheters asap |
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Gram (-) Septicemia- what causes this organism?
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-gram (-) bacteria = 30% of all cases
-gram (+) bacteria -viruses -fungi -400,000 cases a year |
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Gram (-) Septicemia-symptoms
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-violent shaking chills
-fever, anxiety, rapid breathing -as septic shock develops ----urine output decreases ----respirations & pulse increase ----vasoconstriction occurs -symptoms can progress |
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Gram (-) Septicemia-pathogenesis
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-uncontrolled infection caused by surgery, trauma, subluxations.
-immune system over-reacts to endotoxins . -tnf = tumor necrosis factor, interleukin-1 -endotoxin induces clotting, cytokines decrease heart muscle tone -lungs most susceptible to permanent damage from endotoxemia |
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Gram (-) Septicemia- epidemiology
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-mainly a nosocomial infection, infection from a hospital
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Gram (-) Septicemia
prevention/treatment |
-prompt ID and treatment of localized infections.
-anti-microbial agent -measures to control shock (death rate 30-50%) -immunotherapy |
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Tularemia (rabbit's fever)-causative agent
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-Francisella agent (gram -, needs cystein to grow)
-widespread in animals in usa. rabbits, muskrats, bobcats. |
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Tularemia (rabbit's fever)-symptoms
usual and unusual |
usual-skin ulcer, enlarged lymph nodes, fever/achiness
unusual-eye conjunctivitis, lung pneumonia, gi tract vomitinng, diarrhea. 1-4 weeks, sometimes months |
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Tularemia (rabbit's fever)-epidemiology
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skinning rabbits, squirrels, muskrats, beavers.
-portal of entry- unnoticed scratches, mucous membranes, oral cavity via food, lung by inhalation |
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Tularemia (rabbit's fever)-pathogenesis
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-organism enters the skin, travels to lymph nodes via lymph vessels
-nodes fill then drain with pus -pneumonia occurs in 10-15% of cases. 30% lead to death. |
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Tularemia (rabbit's fever)-prevention/treatment
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prevent-gloves,goggles,masks for people skinning animals
-vaccine for lab workers treatment-tetracycline, gentamicin |
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Brucellosis aka "undulant fever" or "bang's disease"-causative agent
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Brucella melitensis.
-abortus-cattle -melitensis-goats -canis-dogs -suis-pigs |
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Brucellosis aka "undulant fever" or "bang's disease"-symptoms
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usually gradual or vague-
-mild fever, sweating, weakness -aches and pains, enlarged lymph nodes -weight losss |
