Micro- Meningitis

Front 1

You are wondering what the specific causative agent of polio is so you do a search on PubMed on a hospital's medical library. What is the causative agent for polio?

Enterovirus picornaviridae

Streptococcus pneumoniae

Naegleria fowleri

Poliovirus intoxicum

Back 1

Enterovirus picornaviridae

Front 2

Which of the following diseases does not require an infection to cause symptoms?

Poliomyelitis

Botulism

Listeriosis

Cryptococcosis

Back 2

Botulism

Front 3

Amanda is a 20-year-old college student who lives on campus. Her roommate brought her into your emergency room, because Amanda is not acting like herself. She was previously healthy, very involved in campus politics, and a 4.0 student. About 2 weeks ago, she started not feeling well. She had bad nasal congestion, and was diagnosed with a sinus infection. However, she decided against taking antibiotics because she did not believe they were good for her. She started getting very high fevers, which Amanda told her roommate were good because they were killing the infection. Yesterday, she started complaining of a stiff neck, and today she seems especially lethargic with a fever of 105. Her roommate was scared, so she forced her into her car and has driven her to your ICU.What is the most likely diagnosis for Amanda?

prolonged sinus infection

meningitis

tumor of the cervical spine

necrotizing encephalitis

Back 3

meningitis

Front 4

Drugs used to treat encephalitis must ________.

enter the lymphatic system

kill gram-positive cocci

be lipid soluble

inhibit acetylcholine

Back 4

be lipid soluble

Front 5

Which of these statements is true concerning foodborne botulism in older children and adults?

Disease usually results from consuming C. botulinum spores in improperly canned foods. These spores germinate and produce toxin within the intestine.

Disease results from toxin produced by vegetative C. botulinum organisms when contaminated foods sit at room temperature between preparation and consumption.

Disease results when ingested C. botulinum spores germinate in the intestine and invade the bloodstream, causing septicemia.

Disease results from consuming vegetative C. botulinum organisms that invade peripheral neurons.

Disease results from consuming botulism toxin in improperly preserved foods.

Back 5

Disease results from consuming botulism toxin in improperly preserved foods.

Front 6

In September 2008, a previously healthy 25-year-old man was admitted with a 24-hour history of fever, vomiting, and neck rigidity. CSF analysis was performed. Test results were negative for bacteria, and wet mount slide preparation of CSF showed motile amebic trophozoites. Despite therapy with intravenous amphotericin B, oral fluconazole, and rifampin, his condition deteriorated, and he died 14 days after admission. Which of the following was most likely the cause of his death?

Naegleria fowleri

Clostridium botulium

Streptococcus pyogenes

Francisella tularensis

Back 6

Naegleria fowleri

Front 7

A discovery channel journalist traveled to Papua New Guinea to film a documentary on a small tribe. His filming took 1 year to complete and while there he immersed himself in the tribal culture and took part in hunting and cooking as well as wedding and funeral rituals. Upon his return he began to feel uncoordinated and experienced a loss of appetite. A CAT scan revealed spongiform encephalopathy. What disease is the journalist suffering from?

Botulism

Tetanus

West Nile

Kuru

Back 7

Kuru

Front 8

A postmortem examination of a brain shows sponge-like degeneration. This is most likely a case of ________.

Poliomyelitis

Rabies

Creutzfeldt-Jakob disease

arboviral encephalitis

Back 8

Creutzfeldt-Jakob disease

Front 9

The normal biota of the CNS consists of:

Neisseria meningitidis.

herpes simplex I.

herpes simplex II.

Streptococcus agalactiae.

The CNS has no normal biota.

Back 9

The CNS has no normal biota.

Front 10

Which of the following is MISMATCHED?

Polio; fecal-oral transmission

Rabies; transmitted by animal bite

Cryptococcus neoformans; associated with chicken and pigeon droppings

Sleeping sickness; transmitted by Tsetse fly

West Nile; transmitted by ticks

Back 10

West Nile; transmitted by ticks

Front 11

The nervous system performs three important functions. Which of the following is NOT one of those functions?

A)sensory

B)circulation

C)integrative

D)motor

Back 11

B)circulation

Front 12

Cerebrospinal fluid (CSF) is

A)found only in the brain.

B)a neurotransmitter.

C)nutritional and cushioning.

D)contained within the dendrites.

Back 12

C)nutritional and cushioning.

Front 13

Meningitis is an infection and inflammation of

A)the grey matter of the brain and associated dendrites.

B)the membranes around the brain.

C)spinal nerves.

D)cranial nerves.

Back 13

B)the membranes around the brain. (meninges)

Front 14

Typical signs and symptoms of meningitis include all of these EXCEPT

A)headache.

B)painful or stiff neck.

C)fever.

D)RBCs in CSF.

Back 14

D)RBCs in CSF.

Front 15

Neisseria meningitidis ("the meningococcus")

A)are Gram positive cocci.

B)is associated with epidemic forms of meningitis.

C)has no capsule.

D)is a minor cause of meningitis.

Back 15

B)is associated with epidemic forms of meningitis.

Front 16

Streptococcus pneumoniae ("the pneumococcus")

A)causes petechiae in the extremities.

B)has no effective vaccine.

C)is the most frequent cause of community-acquired meningitis.

D)is a Gram negative diplococcus.

Back 16

C)is the most frequent cause of community-acquired meningitis.

Front 17

Pregnant women are cautioned not to eat soft, unpasteurized cheeses or meats from delicatessens due to this organism, which can cause meningitis, encephalitis, and septicemia in fetuses and neonates, though it causes little problem in immunocompetent adults.

A)Listeria monocytogenes

B)Cryptococcus neoformans

C)Streptococcus pneumoniae

D)Haemophilus influenza

Back 17

A)Listeria monocytogenes

Front 18

Naegleria fowleri can cause amoebic meningoencephalitis and

A)is very common.

B)invades broken skin and the conjunctiva of the eye.

C)has a long course of infection.

D)is of special concern to people with traumatic eye injuries.

Back 18

A)is very common.

Front 19

Postinfection encephalitis (PIE) is a condition

A)resulting from direct viral invasion.

B)resulting from previous infection with measles and other childhood rash diseases.

C)occurring frequently after immunization with live attenuated vaccines.

D)occurring frequently after immunization with sub-unit vaccine.

Back 19

B)resulting from previous infection with measles and other childhood rash diseases.

Front 20

Toxoplasma gondii, a flagellated parasite, is common. What is it's primary reservoir and host?

A)humans

B)insects

C)birds

D)cats

Back 20

D)cats

Front 21

Subacute sclerosing panencephalitis (SSPE)

A)is called a "fast virus infection."

B)occurs shortly after mumps infections.

C)is caused by indirect viral invasion of skeletal tissue.

D)currently has no treatment and no prevention.

Back 21

D)currently has no treatment and no prevention.

Front 22

Prions are

A)submicroscopic bacteria.

B)viruses.

C)proteinaceous infectious particles.

D)protozoan parasites.

Back 22

C)proteinaceous infectious particles.

Front 23

Creutzfeldt-Jacob Disease (CJD) is found in

A)sheep.

B)cattle.

C)minks.

D)humans.

Back 23

D)humans.

Front 24

Prions cause diseases known collectively as

A)prion-associated encephalitis.

B)spongy encephalitis.

C)transmissible spongiform encephalopathies.

D)non-viral encephalopathies.

Back 24

C)transmissible spongiform encephalopathies.

Front 25

This disease is generally fatal once symptoms have begun. Treatment must begin immediately after exposure to prevent the course of infection.

A)CJD

B)West Nile Virus

C)toxoplasmosis

D)rabies

Back 25

D)rabies

Front 26

Poliovirus has been around for centuries with only minor effects. Why did it suddenly display as the more serious infantile paralysis in the 1900s?

A)It became neurotropic.

B)Vaccination programs for it began.

C)increased public sanitation

D)industrial pollution

Back 26

C)increased public sanitation

Front 27

Rabies can manifest in three forms:

A)viral, bacterial, and aseptic.

B)furious, hydrophobic, and dumb.

C)infective, inhaled, and ingested.

D)none of the above.

Back 27

B)furious, hydrophobic, and dumb.

Front 28

There are three major forms of botulism. Which of the following is not one of the three major forms?

A)food-borne

B)infant

C)inhalation

D)wound

Back 28

C)inhalation

Front 29

Clostridium species tend to

A)form endospores.

B)prefer aerobic conditions.

C)be found in hospitals.

D)do damage because of endotoxins.

Back 29

A)form endospores.

Front 30

Trypanosoma brucei, the cause of sleeping sickness, is able to avoid immune response by

A)capsule glycoproteins.

B)hiding in body cells.

C)living in an alternate host.

D)antigenic shifting.

Back 30

D)antigenic shifting.

Front 31

All of the following can usually be prevented by use of a vaccine EXCEPT for

A)Neisseria meningitidis.

B)Streptococcus pneumoniae.

C)Haemophilus influenza.

D)Listeria monocytogenes.

Back 31

D)Listeria monocytogenes.

Front 32

Subacute encephalitis symptoms

A)occur primarily in neonates.

B)take longer to show and are less striking.

C)result 1-2 weeks after infection with measles or other childhood rash diseases.

D)happen when a virus is reactivated from a dormant state.

Back 32

B)take longer to show and are less striking.

Front 33

What are the structures that make up the brain and spinal cord?

Back 33

neurons

Front 34

Cerebrospinal fluid (CSF) provides _____1____, liquid ___2_____ and is _____3______.

Back 34

1. nutrition

2. liquid cushion

3. sterile

Front 35

The brain and spinal cord are part of the ____1___ nervous system. Where everything else is in the ___2_____ nervous system .

Back 35

1. Central

2. Peripheral

Front 36

The __________ nervous system consists of the cranial and spinal nerves.

Back 36

Peripheral

Front 37

_________ receive and transmit nerve signals

Back 37

nerves

Front 38

_______ and __________ transmit signals

Back 38

synapse

neurotransmitters

Front 39

The blood brain barrier separates the _______ and ______.

Back 39

blood

CSF

Front 40

The blood-brain barrier has tight _____1_____. Small ___2___ __3____ molecules that diffuse throught. __4_____ __5____ drugs: Chloramphenocol. Inflammation causes increased _______6_______.

Back 40

1- junctions

2/3 -non polar

4/5- lipid soluble

6- permeability

Front 41

Microglia are ______ cells that travel around in the brain and they look for bad thingsand clear up any excess cellular pieces and parts that shouldn’t be there.

Back 41

immune

Front 42

Meningitis is inflammation of ____________.

Back 42

meninges

Front 43

Encephalitis is inflammation of the ________

Back 43

brain

Front 44

Meningoencephalitis is inflammation of __________ and __________

Back 44

meninges and brain

Front 45

Common symptoms of meningitis is Fever,_____1______ , stiff neck. Followed by ____2____ and vomiting. Extreme sensitivity to ____3_____. It can sometimes cause a ___4___.

Back 45

1. headache

2. nausea

3. light

4. rash

Front 46

Meningitis may progress to ____1______ and ___2____.

Back 46

convulsions

coma

Front 47

How is meningitis diagnosed?

Back 47

Increased lymphocytes in CSF

Gram stain

Front 48

Meningitis is treated with ________ spectrum antibiotics.

Back 48

broad spectrum

Front 49

Meningitis is treated with what two antibiotics?

Back 49

Cephalosporins

Vancomysin

Front 50

What can cause meningitis?

Back 50

Bacteria

fungus

virus

Front 51

What bacteria's cause meningitis?

Back 51

•Neisseria meningitidis

•Streptococcus pneumoniae

•Haemophilus influenzae

•Listeria monocytogenes

Front 52

What fungus can cause meningitis?

Back 52

Cryptococcus neoformans

Front 53

What viruses can cause meningitis?

Back 53

Viral meningitis

Front 54

Neisseria meningitidis is also known as

Back 54

meningococcus

Front 55

Neisseria meningitidis (meningococcus) causes the most serious forms of _______ meningitis

Back 55

acute

Front 56

Neisseria meningitidis (meningococcus)is a gram (+/-), diplo______

Back 56

negative

cocci

Front 57

Neisseria meningitidis (meningococcus ) virulence factors include: ___1____ that helps evade phagocytes and __2__ ____3_____.

Back 57

1. capsule

2/3. igA protease

Front 58

in Neisseria meningitidsi meningococcus) 3-30% of people are carriers in their ________ and _________. and 50% of people who work in institutional settings are carriers.

Back 58

nose

throat

Front 59

How is Neisseria meningitidis (meningococcus ) transmitted?

Back 59

families and facilities

Front 60

Because Neisseria meningitidis (meningococcus) produces igA protease, it can pass the _______ _______.

Back 60

mucus membrane

Front 61

Neisseria meningitidis (meningococcus) can cause one to ______________. and develop petechiae (red/purpose spots due to blood in the skin)

Back 61

hemorrhage

Front 62

Common signs and symptoms of Neisseria meningitidis (meningococcus) are :

sudden onset of disease, soar __1_____, fever of ___2___(temp), chills, delirium, widespread ___3____ under the skin, generalized intravascular ____4____, shock; ___5____, cardiac failure.

Back 62

1. Throat

2. 104

3. bleeding

4. clotting

5. coma

Front 63

Neisseria meningitidis (meningococcus) has a _____% mortality rate

Back 63

15

Front 64

people who have Neisseria meningitidis (meningococcus) often die within _____ to ______ hours if left untreated

Back 64

9-12

Front 65

Streptococcus pneumoniae can cause what bacterial infection in the brain?

Back 65

Pneumococcal meningitis

Front 66

Pneumococcal meningitis is gram (+/-) and is a normal biota of the _______2______.

____3___% of the population are carriers.

Back 66

1. positive

2. nasopharynx

3. 70%

Front 67

Pneumococcal meningitis have virulence factors such as: ___1_____ that prevent phagocytosis, __2__-hemolysin, H202 which produce catalase and induces brain cell ______3______.

Back 67

1. capsule

2. alpha

3. apoptosis

Front 68

Pneumococcal meningitis penetrates the ______1_______ musoca and enters the _____2_____ where it gains access to the _____3_______.

Back 68

1. respiratory

2. bloodsteam

3. meninges

Front 69

Pneumococcal meningiti (streptococcus pneumoniae) is typically transmitted to ________

Back 69

children between 1-48 months

Front 70

The mortality rate for Pneumococcal meningiti is _____% in children and ______% in elderly

Back 70

30

80

Front 71

Haemophilusinfluenzae can causes _____________ in the brain.

Back 71

meningitis

Front 72

Haemophilusinfluenzae is a gram (+/-), rod and is a noral biota of the _________.

Back 72

negative

throat

Front 73

Haemophilusinfluenzae has virulence factors that include: ____________ and antigen type _____.

Back 73

capsule

B

Front 74

Haemophilusinfluenzae enters the _________ where is then reaches the _________.

Back 74

bloodstream

meninges

Front 75

Haemophilusinfluenzae is transmitted typically to ____________.

Back 75

children (6-48 months)

Front 76

What is the mortality rate for Haemophilusinfluenzae?

Back 76

>6% because of Hib vaccine

Front 77

Hib vaccine is to help prevent

Back 77

Haemophilusinfluenzae type B

Front 78

Listeria monocytogenes can cause ___________.

Back 78

meningitis

Front 79

Listeriamonocytogenes is Gram (+/-) and is _______2______ because it has 1-4 flagella.

Back 79

positive

pleomorphic

Front 80

Common Listeriamonocytogenes signs and symptoms in immunocompetent people are ______1______ and _____2____.

Back 80

Mild, subclinical

Front 81

Common Listeria monocytogenes signs and symptoms in immunocompromised people are: affects the brain, ____1_____, and causes _____2_______. Death rate is __3___%

Back 81

1. meninges

2. septicemia

3. 20

Front 82

Common Listeria monocytogenes signs and symptoms in pregnant women include: _____1_______ infections, premature ____2_______ and ____3____.

Back 82

1. intrauterine

2. abortion

3. death

Front 83

Listeria monocytogenes is not _____1______. (intra or extra cellular 2) pathogen and it reproduces in ____3_______.

Back 83

1. fastidious

2. intracellular

3. phagocytes

Front 84

Listeria monocytogenes transmission is __________.

Back 84

foodborne (soil and water)

Front 85

Listeria monocytogenes can grow at _______ degrees Celsius .

Back 85

4

Front 86

Listeria monocytogenes have flagella that coats itself with ______________ and shoots across to the next cell.

Back 86

cytoskeleton

Front 87

Cryptococcusneoformans is a __1______ that causes _____2_______.

Back 87

1.Fungus

2.meningitis

Front 88

Cryptococcus neoformans is __1___ shaped and has a large ____2_____.

Back 88

1. ovoid

2. capsule

Front 89

Cryptococcus neoformans is a _______ form of meningitis

Back 89

chronic

Front 90

Cryptococcus neoformans has a ____1_____ onset of symptoms and is commonly found in _______2_________ people.

Back 90

1.gradual

2. immunocompromised

Front 91

Cryptococcus neoformans is transmitted from ____1____ and ___2____ droppings via ____3_____.

Back 91

1. pigeon

2. chicken

3. inhalation

Front 92

Viral meningitis is a type of _________ meningitis; no bacteria or fungi in CSF

Back 92

aseptic

Front 93

Viral meningitis is caused by what virus?

Back 93

Enterovirus

Front 94

The common signs and symptoms of viral meningitis is are generally ____1___ than bacteria or fungal meningitis. Usually resolved within ___2___ weeks. Mortality rate is __3___%

Back 94

1. milder

2. 2

3. less than 1%

Front 95

Neonatal meningitis is almost always transmitted by the _____1_______. In ____2___ or during passage through the ____3____ ____4____.

Back 95

1. mother

2. utero

3/4. birth canal

Front 96

Neonatal meningitis is caused by what etiological agents?

Back 96

Streptococcus agalactiae

Escherichia coli K1(Brain damage, 20% mortality rate)

Listeria monocytogenes