18

The fibrous sac that encloses the heart is the
pericardium.
The presence of viruses in the blood is called
viremia.
______ occurs when bacteria flourish and grow in the blood stream.
Septicemia
All of the following are associated with subacute endocarditis except
A. occurs in patients that have prior heart damage.
B. caused by immune system autoantibodies that attack heart and valve tissue.
C. oral bacteria get introduced by dental procedures to the blood.
D. bacteria colonize previously damaged heart tissue resulting in a vegetation.
E. signs and symptoms include fever, heart murmur, and possible emboli.
caused by immune system autoantibodies that attack heart and valve tissue.
The common causative agent of acute endocarditis is
A. Staphylococcus aureus.
B. Streptococcus pneumoniae.
C. Streptococcus pyogenes.
D. Neisseria gonorrhaeae.
E. All of the choices are correct.
Acute endocarditis is most commonly contracted through
parenteral entry.
Most cases of septicemia are caused by
bacteria.
Which of the following is not true of septicemia?
respiratory acidosis
Yersinia pestis
is usually transmitted by a flea vector.
All of the following are associated with bubonic plague except
transmitted by human feces
Which is incorrect about Yersinia pestis?
A. exhibits bipolar staining
B. gram-negative rod
C. transmitted by fleas
D. has a capsule
E. produces enterotoxin
produces enterotoxin
Plague includes
A. septicemic form; called Black Death. B. bubonic form; buboes develop. C. pneumonic form; sputum highly contagious. D. disease control; control of rodent population. E. All of the choices are correct.
Bubonic plague is transmitted by
fleas.
Control of rodent populations is important for preventing
plague.
Which is not associated with tularemia?
a gram-positive bacterium
Rabbits and other rodents are the reservoirs of the causative agent of
tularemia.
The causative agent of Lyme disease is
Borrelia burgdorferi.
Erythema migrans, a bull’s-eye rash, at the portal of entry is associated with
Lyme disease.
The white-footed mouse, deer, and deer ticks are important to maintaining the transmission cycle associated with
Lyme disease.
Lyme disease involves
A. early symptoms of fever, headache, and stiff neck.
B. crippling polyarthritis, and cardiovascular and neurological problems.
C. people having contact with ticks.
D. treatment with antimicrobials.
E. All of the choices are correct.
Lyme disease is transmitted by
ticks.
Epstein-Barr virus has the following characteristics except it
is more commonly found in adults.
Symptoms of infectious mononucleosis include
sore throat, fever, cervical lymphadenopathy, and splenomegaly.
Which of the following requires direct contact with infected body fluids?
Lassa fever
Which of the following is a hemorrhagic fever?
yellow fever
Yellow fever and dengue fever are
A. caused by arboviruses.
B. caused by viruses that disrupt capillaries and blood clotting.
C. zoonoses.
D. transmitted by a mosquito vector.
E. All of the choices are correct.
Which of the following is not true of Ebola and Marburg?
transmitted by mosquitos
Which type of hemorrhagic fever can be treated with ribavirin?
Lassa fever
Which type of hemorrhagic fever is also known as “breakbone fever” because of the severe pain in bones?
dengue fever
The reservoir for Lassa fever is the
rat.
Brucellosis is
A. a zoonosis.
B. seen in the patient as a fluctuating fever, with headache, muscle pain, and weakness.
C. also known as undulant fever.
D. an occupational illness of people that work with animals.
E. All of the choices are correct.
Pasteurization of milk helps to prevent
brucellosis.
The gram-negative bacillus associated with abscesses from cat bites or scratches is
Bartonella henselae.
Rocky Mountain spotted fever
symptoms include fever, headache, and rash.
Which is incorrect regarding Q fever?
transmitted by lice
Which of the following is mismatched?
Rickettsia typhi – Rocky Mountain spotted fever
Cat-scratch fever can be prevented by
cleaning the scratch wound.
The symptoms that occur in cyclic 48 to 72 hour episodes in a malaria patient are
chills, fever, and sweating.
Which is incorrect about malaria?
merozoites enter and multiply in liver cells
The cyclic bouts of fever and chills in malaria are caused by
red blood cell lysis.
Malaria may be prevented by
A. using bed nets sprayed with insecticide.
B. eliminating standing water.
C. taking prophylactic drugs.
D. decreasing the mosquito population.
E. All of the choices are correct.
The causative organism of malaria is a
protozoan.
Characteristics of Bacillus anthracis include all the following except
a one-time vaccine provides lifelong immunity.
Anthrax is
A. a zoonosis.
B. transmitted by contact, inhalation, and ingestion.
C. a disease that, in humans, can cause a rapidly fatal toxemia and septicemia.
D. only seen sporadically in the United States.
E. All of the choices are correct.
The preferred treatment for anthrax is
doxycycline.
A common cardiovascular/lymph system disease in AIDS patients is
Burkitt’s lymphoma.
Retroviruses have the following characteristics except
DNA genome.
All of the following pertain to patients with AIDS except they
have the highest number of cases worldwide in the United States.
Documented transmission of HIV involves
unprotected sexual intercourse and contact with blood/blood products.
All of the following pertain to HIV except
A. attaches primarily to host cells with CD4 receptors.
B. initial infection often associated with vague symptoms.
C. becomes latent in host cells.
D. ELISA and Western blot tests detect HIV antigens.
E. can enter into nervous tissues and cause abnormalities.
ELISA and Western blot tests detect HIV antigens.
Which drugs interfere with the action of an HIV enzyme needed for final assembly and maturation of the virus?
protease inhibitors
Which new class of drugs will interfere with docking onto host cells?
fusion inhibitors
A frequent cancer that is seen in AIDS patients is
Kaposi’s sarcoma.
The cardiovascular and lymphatic systems have no normal biota.
TRUE
Plague is a quarantinable disease.
TRUE
Lyme disease is only seen in people living in Lyme, Connecticut.
FALSE
A vaccine for Lyme disease is available.
FALSE
Aedes mosquitoes are the vectors involved in yellow fever and dengue fever.
TRUE
In severe cases of Rocky Mountain spotted fever, the enlarged lesions of the rash can become necrotic and predispose the patient to gangrene of toes and fingertips.
TRUE
The highest numbers of cases of Rocky Mountain spotted fever occur along the eastern seaboard.
TRUE
Rifampin is the drug of choice for malaria.
FALSE
The leading cause of morbidity and mortality in AIDS patients is Pneumocystis pneumonia.
TRUE
Under normal healthy circumstances the lymphatic system filters any microorganisms present.
TRUE
What is the cause of the cyclical nature of Nani’s symptoms?
It is secondary to the synchronous rupture of RBCs.
If you had the ability to perform more thorough blood tests on Nani, what would you expect to find?
hypoglycemia, decreased RBCs
You approach the physician you are reporting to at the moment with Nani’s clinical diagnosis and findings. However, before you even approach him, you are well aware of what treatment he is going to order. In this case, what is the first line treatment?
chloroquine and doxycycline
If Nani refuses treatment, or treatment is not successful, what may be the ultimate cause of death?
multiorgan failure
What preventive measures should you recommend to Nani’s family who has accompanied her?
use of bed nets
Suzanne wants to know the risk of her child being HIV positive. What is the risk?
It is impossible to know if HIV will be passed on to the child, but you can decrease the chances by vigilant antiretroviral therapy.
Suzanne knows that she acquired HIV from a previous sexual partner. What is the primary mode of transmission of HIV?
sexual contact and blood
What has been the most successful treatment in reducing transmission of HIV from mother to baby?
protease inhibitors
When should Suzanne’s newborn baby be tested for HIV, assuming she does not breastfeed?
at birth and 6 months of age
As Suzanne is leaving her appointment, you decide to give her some advice on prevention measures. What is the best form of prevention for HIV, assuming sexual abstinence is not an option?
use of barrier-method contraceptive
What is the most likely diagnosis?
bacterial septicemia
What is the likelihood that this presentation is fungal in nature?
10%
The doctors decide that Jennifer is septic, and administer several boluses of normal saline while having you place her on vasoactive drugs to increase her blood pressure. What are the important next steps?
respiratory support, blood cultures, and antibiotics
It is discovered through Gram stain that the offending microorganism is gram-positive cocci in grape-like clusters. Although the final culture has not come back yet, which organism can you best assume is responsible?
Staphylococcus aureus
Your suspicions are confirmed a few days later, with S. aureus being the primary organism responsible for Jennifer’s septicemia. Although empiric antibiotic therapy was initiated, what is the next step?
narrow antibiotic coverage as indicated
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