Chapter 019

Chapter 019 Infectious Diseases Affecting the Nervous System Key
Multiple Choice Questions

1.
Cerebrospinal fluid is found in the

A. Pia
mater
B. Dura
mater
C. Subarachnoid
space
D. Arachnoid
mater
E. All of the choices are
correct
Learning Objective: 19.01 Describe the important anatomical features of the nervous system.
2.
Place the following in order from skull to brain: 1) Subarachnoid space 2)

Arachnoid mater 3) Dura mater 4) Pia mater
A. Subarachnoid space, arachnoid mater, dura mater,
pia mater
B. Dura mater, arachnoid mater, subarachnoid space,
pia mater
C. Dura mater, arachnoid mater,4, subarachnoid
space
D. Arachnoid mater, subarachnoid space, dura mater,
pia mater
E. Pia mater, arachnoid mater, subarachnoid space,
dura mater
3.
The concept of "immunologically privileged" explains why the CNS

A. Has a greater immune response than the rest of
the body
B. Has a reduced immune response compared to the rest of
the body
C. Has a completely different set of immune
responses
D. Has more MHC markers than other
tissues
correct
Learning Objective: 19.02 List the natural defenses present in the nervous system.
4.
Which type of neuroglia has phagocytic capabilities in the CNS?

A. Astrocyt
es
B. Schwann
cells
C. Macrophag
es
D. Microglial
cells
E. Neuron
s
5.
What brain defense restricts substances from entering the brain by the vascular
system?
A. Meninge
s
B. Blood-brain
barrier
C. Macrophag
es
D. Microgli
a
E. Craniu
m
6.
The normal biota of the CNS consists of

A. Neisseria
meningitidis
B. Herpes
simplex I
C. Herpes
simplex II
D. Streptococcus
agalactiae
E. The CNS has no normal
biota
Learning Objective: 19.03 Talk about the normal biota of the nervous system and the background behind it.
7.
Meningococcemia is
A. Best treated with
penicillin G
B. Associated with vascular collapse, hemorrhage and
petechiae
C. Started from a nasopharyngeal
infection
D. Caused by a gram negative
diplococcus
correct
Learning Objective: 19.04 List the possible causative agents
Learning Objective: diagnostic techniques and prevention/treatment for meningitis and also for neonatal meningitis.
Learning Objective: modes of transmission
Learning Objective: virulence factors
8.
All of the following pertain to Neisseria meningitidis except

A. Virulent factors include a capsule, pili, endotoxin and IgA
protease
B. Causes a serious
meningitis
C. Reservoir is the nasopharynx of human
carriers
D. More easily transmitted in day care facilities, dorms and
military barracks
E. Common cause of bacterial
pneumonia
9.
Which of the following is a sign of meningitis?

A. Headach
e
B. Stiff
neck
C. White blood cells in cerebrospinal
fluid
D. Feve
r
correct
10.
Meningococci initially colonize the

A. Lacrimal
ducts
B. Oral
mucosa
C. Nasophary
nx
D. Eustachian
tube
correct
11.
Neisseria meningitidis is transmitted by

A. Casual
contact
B. Close
contact
C. Intimate
contact
D. Indirect
contact
E. Fomite
s
12.
Treatment for Neisseria meningitidis consists of

A. Vancomyci
n
B. Penicillin G
orally
C. Penicillin G
intravenously
D. Rifampi
n
E. Tetracyclin
e
13.
Which of the following is not true of Streptococcus pneumoniae?

A. Most frequent cause of community acquired
meningitis
B. Has a polysaccharide capsule that resists
phagocytosis
C. Produces alpha-hemolysin and hydrogen
peroxide
D. Small gram-positive flattened
coccus
E. Responds well to
penicillin
14.
Which of the following is caused by Haemophilus influenzae?

A. Bacterial
meningitis
B. Influenza
(flu)
C. Otitis
media
D. Bronchit
is
E. Epiglottit
is
Learning Objective: 19.05 Identify the most common and also the most deadly of the multiple possible causes of meningitis.
15.
The virulence of Haemophilus influenzae serotype b is associated with its

A. Fimbria
e
B. Neurotox
in
C. Enterotox
in
D. Capsul
e
E. None of the choices are
correct
16.
Prophylactic rifampin is indicated for individuals in close contact with patients

infected by
A. Haemophilus
influenzae
B. Listeria
monocytogenes
C. Cryptococcus
neoformans
D. Coccidiodes
immitis
E. Streptococcus
agalactiae
17.
Each of the following is true for Listeria monocytogenes except

A. Resistant to
cold
B. Fastidiou
s
C. Resistant to
heat
D. Resistant to
salt
E. Can result in
septicemia
18.
Which organism is a common cause of meningitis in AIDS patients and can be

found in bird droppings?
A. Listeria
monocytogenes
B. Haemophilus
influenza
C. Neisseria
meningitidis
D. Cryptococcus
neoformans
E. Streptococcus
agalactiae
19.
Cryptococcus neoformans is a
A. Viru
s
B. Bacteri
a
C. Prio
n
D. Fungu
s
E. Helmint
h
20.
Agricultural workers and field archaeologists are exposed to this organism which
although entering via the respiratory tract can cause meningitis.
A. Haemophilus
influenzae
B. Coccidioides
immitis
C. Cryptococcus
neoformans
D. Streptococcus
pneumoniae
E. Neisseria
meningitidis
21.
Arthrospores of Coccidioides immitis develop into _____ that will release

endospores into the lungs.
A. Hypha
e
B. Capsule
s
C. Spherule
s
D. Capsid
s
E. Bud
s
22.
Although many viruses can cause meningitis, the most common viral cause is
A. Herpes
simplex
B. Cytomegalovir
us
C. Arbovir
us
D. Enterovir
us
E. Arenavir
us
23.
Neonatal meningitis is most commonly transmitted by

A. Breast
feeding
B. Hospital
personnel
C. Transplacental
infection
D. Exposure in birth
canal
E. Exposure from other
infants
24.
The organism responsible for the majority of neonatal meningitis is

A. Streptococcus
agalactiae
B. Escherichia coli
K1
C. Listeria
monocytogenes
D. Haemophilus
influenzae
E. Neisseria
meningitidis
25.
The organism found in powdered baby formula which can cause meningitis is:
A. Escherichia coli
O157:H7
B. Escherichia coli
K1
C. Enterobacter
sakazakii
D. Streptococcus
agalactiae
E. Cryptococcus
neoformans
26.
Which of the following is not true of meningoencephalitis?

A. Causative organisms are Naegleria fowleri and
Acanthamoeba
B. Infections of both the brain and
meninges
C. Causative organisms are
viruses
D. Modes of transmission are direct contact and swimming in warm
fresh water
E. Treatment for Primary Amoebic Meningoencephalitis is mostly
ineffective
Learning Objective: and subacute encephalitis.
Learning Objective: diagnostic techniques and prevention/treatment for diseases most directly involving the brain. These are:
meningoencephalitis
Learning Objective: encephalitis
27.
Which of the following is not a causative agent of acute encephalitis?

A. JC
virus
B. Arbovir
us
C. Herpes simplex
virus
D. Toxoplasma
gondii
E. Varicella-zoster
virus
Learning Objective: 19.07 Identify which viruses that can cause encephalitis you should be on the lookout for in your geographical
area.
28.
Encephalitis caused by arboviruses involves

A. Fever, headache and
rash
B. Coma, convulsions, paralysis in severe
cases
C. Myalgia and orbital
pain
D. Muscle aches and joint
stiffness
correct
area.
29.
Encephalitis is most commonly caused by a

A. Bacteri
a
B. Protozoa
n
C. Viru
s
D. Helmint
h
correct
area.
30.
What is the likelihood of a patient infected by West Nile Virus developing West Nile
encephalitis?
A. Less than
1%
B. Between 1% and
10%
C. Between 10% and
15%
D. Greater than
20%
E. Greater than
50%
area.
31.
The best defense against arborviruses is

A. Prophylactic
rifampin
B. Vector
control
C. Vaccinatio
n
D. Prompt treatment with
acyclovir
correct
area.
32.
Which of the following have the highest mortality rate?

A. Western Equine
Encephalitis
B. St. Louis
Encephalitis
C. California
Encephalitis
D. Eastern Equine
Encephalitis
E. West Nile
Encephalitis
area.
33.
Each of the following are true for Toxoplasma gondii except

A. It is a flagellated
parasite
B. It is often fatal for AIDS
patients
C. Can cause
stillbirth
D. Has a narrow host
range
true
meningoencephalitis
34.
What organism is the main reservoir and host for Toxoplasma gondii?
A. Ca
t
B. Do
g
C. Mous
e
D. Mosquit
o
E. Raccoo
n
meningoencephalitis
35.
Toxoplasmosis prevention includes

A. Vaccination of
humans
B. Vaccination of
cats
C. Hygienic
precautions
D. Vector
control
correct
meningoencephalitis
36.
Spongiform encephalopathies are

A. Associated with abnormal, transmissible, protein in
the brain
B. Chronic, fatal infections of the nervous
system
C. Caused by
prions
D. Creutzfeld-Jacob disease, kuru and Gertsmann-Straussler-Scheinker
syndrome
correct
meningoencephalitis
37.
Which of the following is not a prion disease?

A. Scrapi
e
B. Creutzfeldt-Jacob
disease
C. Bovine spongiform
encephalopathy
D. Subacute sclerosing
panencephalitis
E. All of the choices are prion
diseases
meningoencephalitis
38.
Patients with Creutzfeldt-Jacob disease live

A. Less than one year post
diagnosis
B. 1 to 5 years post
diagnosis
C. 5 to 10 years post
diagnosis
D. 10 to 20 years post
diagnosis
E. Greater than 25 years post
diagnosis
meningoencephalitis
39.
Prions can be transmitted by all of the following except

A. Ingesting brain
material
B. Ingesting meat from infected
animals
C. Surgical
instruments
D. Cornea
transplants
E. All of the choices are ways of prion
transmission
meningoencephalitis
40.
Subacute encephalitis may be caused by

A. Toxoplasma
gondii
B. Prion
s
C. Herpes simplex
virus
D. Persistent measles
virus
correct
meningoencephalitis
41.
Which is incorrect about rabies?

A. Is a zoonotic
disease
B. Wild populations of bats, skunks, raccoons, cats and canines are primary
reservoirs
C. Transmission can involve bites, scratches and
inhalation
D. Average incubation in human is 1
week
E. Symptoms include anxiety, agitation, muscle spasms, convulsions,
paralysis
Learning Objective: botulism and African sleeping sickness.
Learning Objective: diagnostic techniques and prevention/treatment for other diseases in the nervous system. These are: rabies
Learning Objective: poliomyelitis
Learning Objective: tetanus
42.
Treatment of an animal bite for possible rabies includes

A. Debrideme
nt
B. Washing bite with soap or
detergent
C. Infusing the wound with human rabies immune
globulin (HRIG)
D. Postexposure vaccination with inactive
vaccine
correct
43.
All of the following pertain to poliomyelitis except

A. Summer outbreaks in the U.S. have been recently
increasing
B. Transmitted primarily by fecal
contaminated water
C. Can be asymptomatic or mild with headache, sore throat, fever
and nausea
D. If virus enters the central nervous system motor, neurons can be infected
and destroyed
E. Caused by Poliovirus (genus
Enterovirus)
44.
Polio virus initially multiplies in the

A. Intestin
e
B. CNS
C. Tonsil
s
D. Nasal
mucosa
E. None of the choices are
correct
45.
In paralytic polio, what structures are damaged?

A. Peripheral
nerves
B. Diaphrag
m
C. Anterior horn
cells
D. Sensory
nerves
E. Brain
stem
46.
The preferred preventative measure for polio in the United States is

A. Inactive vaccine developed by Jonas
Salk
B. Oral, active vaccine developed by Jonas
Salk
C. Inactive vaccine developed by Albert
Sabin
D. Oral, active vaccine developed by Albert
Sabin

Learning Objective: 19.09 Explain the difference between the oral polio vaccine and the inactivated polio vaccine and under which
circumstances each is appropriate.
47.
Production of a neurotoxin that binds to target sites on spinal cord neurons

responsible for inhibiting skeletal muscle contraction is a characteristic of
A. Clostridium
botulinum
B. Clostridium
perfringens
C. Clostridium
difficile
D. Clostridium
tetani
correct
48.
The foodborne disease that involves neurotoxin is

A. Gastrointestinal
anthrax
B. Bacillus cereus
intoxication
C. Botulis
m
D. Clostridium perfringens
gastroenteritis
correct
49.
Production of a neurotoxin that prevents acetylcholine release from motor neurons

at neuromuscular junctions is a characteristic of
A. Clostridium
botulinum
B. Clostridium
perfringens
C. Clostridium
difficile
D. Clostridium
tetani
correct
50.
Which of the following pertains to both tetanus and foodborne botulism?

A. Occurs when spore-contaminated soil enters deep
wounds
B. Caused by enterotoxins of the
pathogen
C. Exotoxin blocks acetylcholine
release
D. Nausea and diarrhea are
symptoms
E. Treatment involves antitoxin
therapy
51.
Tetanus differs from botulism in that

A. Tetanus results in flaccid paralysis while botulism
paralysis is rigid
B. Tetanus results from an exotoxin, botulism from an
endotoxin
C. There is a vaccine for tetanus not for
botulism
D. Muscles cannot relax in tetanus, muscles cannot contract in
botulism
true
52.
Which is the exotoxin of botulism?

A. Hemolysi
n
B. Tetanospas
m
C. Peroxidase
s
D. Factor
V
E. Botulinu
m
53.
African sleeping sickness is caused by

A. Trypanosoma
cruzi
B. Trypanosoma
brucei
C. Leishmania
brasiliensis
D. Isospora
belli
E. Plasmodium
falciparum
54.
The vector involved in African sleeping sickness is the

A. Reduviid, "kissing",
bug
B. Tsetse
fly
C. Anopheles
mosquito
D. Phlebotomine (sand)
fly
E. Hard bodied
tick
True / False Questions

55.
Pneumovax is a vaccine for prevention of disease caused by strains of Neisseria

meningitidis.
FALSE
56.
Cryptococcal meningitis is highly communicable among humans.

FALSE
57.
Viral meningitis normally requires aggressive antiviral treatment.

FALSE
58.
Subacute sclerosing panencephalitis is caused by a prion.

FALSE
meningoencephalitis
59.
Some cases of CJD may be caused by a mutation of the Prp gene.

TRUE
meningoencephalitis
60.
Prions can be destroyed by autoclaving.

FALSE
meningoencephalitis
61.
In rabies, spasms of muscles for swallowing leads to a fear of water.

TRUE
62.
Up to 50% of persons who survived polio as children will suffer from post-polio
syndrome later in life.
TRUE
63.
Tetanus can be prevented with the DTaP childhood immunization and boosters of
the tetanus toxoid.
TRUE
64.
Botulism is often referred to as lockjaw.

FALSE
65.
In both botulism and tetanus, respiratory muscles cannot facilitate breathing and,
if untreated, respiratory collapse leads to death.
TRUE
66.
Botox injections contain botulin toxin.

TRUE
67.
The oral and inactivated polio vaccines are made from plant cell cultures.
FALSE
68.
Children with hypogammaglobulinemia are at risk for developing polio if given the
oral polio vaccine.
TRUE
69.
No cases of attenuated polio virus reverting to a neurovirulent strain have been

documented.
FALSE
Chapter 019 Infectious Diseases Affecting the Nervous System Summary

Category
# of Que
stions
Learning Objective: 19.03 Talk about the normal biota of the nervous system and the background behind it.
Learning Objective: 19.05 Identify the most common and also the most deadly of the multiple possible cause
s of meningitis.
Learning Objective: 19.07 Identify which viruses that can cause encephalitis you should be on the lookout for
in your geographical area.
Learning Objective: 19.09 Explain the difference between the oral polio vaccine and the inactivated polio vac
cine and under which circumstances each is appropriate.
1
17
5
12
6
20
4
12
20
Learning Objective: diagnostic techniques and prevention/treatment for diseases most directly involving the
brain. These are: meningoencephalitis
12
Learning Objective: diagnostic techniques and prevention/treatment for meningitis and also for neonatal me
ningitis.
17
Learning Objective: diagnostic techniques and prevention/treatment for other diseases in the nervous syste
m. These are: rabies
20
12
49
20
20
49

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Chapter 019 Infectious Diseases Affecting the Nervous System Key

Multiple Choice Questions

Cerebrospinal fluid is found in the

Place the following in order from skull to brain: 1) Subarachnoid space 2)

The concept of "immunologically privileged" explains why the CNS

Which type of neuroglia has phagocytic capabilities in the CNS?

The normal biota of the CNS consists of

All of the following pertain to Neisseria meningitidis except

Which of the following is a sign of meningitis?

Meningococci initially colonize the

Neisseria meningitidis is transmitted by

Learning Objective: virulence factors

Treatment for Neisseria meningitidis consists of

Which of the following is not true of Streptococcus pneumoniae?

Which of the following is caused by Haemophilus influenzae?

The virulence of Haemophilus influenzae serotype b is associated with its

Prophylactic rifampin is indicated for individuals in close contact with patients

Each of the following is true for Listeria monocytogenes except

Which organism is a common cause of meningitis in AIDS patients and can be

Arthrospores of Coccidioides immitis develop into _____ that will release

Neonatal meningitis is most commonly transmitted by

The organism responsible for the majority of neonatal meningitis is

Which of the following is not true of meningoencephalitis?

Which of the following is not a causative agent of acute encephalitis?

Encephalitis caused by arboviruses involves

Encephalitis is most commonly caused by a

The best defense against arborviruses is

Which of the following have the highest mortality rate?

Each of the following are true for Toxoplasma gondii except

Toxoplasmosis prevention includes

Spongiform encephalopathies are

Which of the following is not a prion disease?

Patients with Creutzfeldt-Jacob disease live

Prions can be transmitted by all of the following except

Subacute encephalitis may be caused by

Which is incorrect about rabies?

Treatment of an animal bite for possible rabies includes

All of the following pertain to poliomyelitis except

Polio virus initially multiplies in the

In paralytic polio, what structures are damaged?

The preferred preventative measure for polio in the United States is

Learning Objective: 19.08 List the possible causative agents

Production of a neurotoxin that binds to target sites on spinal cord neurons

The foodborne disease that involves neurotoxin is

Production of a neurotoxin that prevents acetylcholine release from motor neurons

Which of the following pertains to both tetanus and foodborne botulism?

Tetanus differs from botulism in that

Which is the exotoxin of botulism?

African sleeping sickness is caused by

The vector involved in African sleeping sickness is the

True / False Questions

Pneumovax is a vaccine for prevention of disease caused by strains of Neisseria

Learning Objective: virulence factors

Cryptococcal meningitis is highly communicable among humans.

Viral meningitis normally requires aggressive antiviral treatment.

Subacute sclerosing panencephalitis is caused by a prion.

Some cases of CJD may be caused by a mutation of the Prp gene.

Prions can be destroyed by autoclaving.

In rabies, spasms of muscles for swallowing leads to a fear of water.

Learning Objective: virulence factors

Botulism is often referred to as lockjaw.

Botox injections contain botulin toxin.

No cases of attenuated polio virus reverting to a neurovirulent strain have been

Chapter 019 Infectious Diseases Affecting the Nervous System Summary