Test Bank for Microbiology with Diseases by Body System ... · bank-for-microbiology-with-diseases-by-body-system-3rd-edition-by-bauman Chapter 21 Microbial Cardiovascular and Systemic

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Chapter 21 Microbial Cardiovascular and Systemic Diseases

21.1 Multiple-Choice Questions

1) Which of the following vessels carries blood from the heart to the rest of the

body?

A) the aorta

B) the superior vena cava

C) the inferior vena cava

D) the pulmonary arteries

E) capillaries

Answer: A

Bloom’s Rank: Knowledge

Section: Structure of the Cardiovascular System

2) Whole blood with the formed elements and clotting proteins removed is called

A) plasma.

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B) lymph.

C) serum.

D) CSF.

E) axenic.

Answer: C



3) Blood is found in which of the following areas of the heart just before it is

pumped into the lungs?

A) the left ventricle

B) the right atrium

C) the right ventricle

D) the superior vena cava

E) the left atrium

Answer: C



4) Which of the following types of bacterial toxins is associated exclusively with

Gram-negative bacteria?

A) endotoxin

B) cytotoxin

C) neurotoxin

D) both endotoxin and cytotoxin

E) both cytotoxin and neurotoxin

Answer: A

Bloom’s Rank: Comprehension

Section: Bacterial Cardiovascular and Systemic Diseases

5) Infection of the lymphatic vessels is known as

A) disseminated intravascular coagulation.

B) bacteremia.

C) lymphangitis.

D) petechiae.

E) recurrent fever.

Answer: C



6) Toxic shock-like syndrome is associated with

A) Pseudomonas aeruginosa.

B) Staphylococcus pyogenes.

C) Streptococcus aureus.

D) Neisseria meningitidis.

E) Escherichia coli.

Answer: C



7) A person is brought to the emergency room with constant high fever, extensive

edema, low blood pressure, and petechiae. Which of the following may the person

be suffering from?

A) septicemia

B) plague

C) Lyme disease

D) brucellosis

E) infectious mononucleosis

Answer: A

Bloom’s Rank: Application


8) Disseminated intravascular coagulation is a complication of which of the

following?

A) endocarditis

B) brucellosis

C) Lyme disease

D) malaria

E) septicemia

Answer: E



9) Vegetations are associated with which of the following disease processes?

A) septicemia

B) endocarditis

C) tularemia

D) plague

E) toxoplasmosis

Answer: B



10) Unprotected contact with the bodily fluids of an infected animal may result in

A) African sleeping sickness.

B) brucellosis.

C) blackwater fever.

D) Lyme disease.

E) toxoplasmosis.

Answer: B



11) The chief diagnostic sign of brucellosis is

A) petechiae.

B) jaundice.

C) “bull’s eye” rash.

D) fever which recurs at 24 hour intervals.

E) fever which cycles every 72 hours.

Answer: D



12) Which of the following statements concerning Francisella is FALSE?

A) It resists phagocytosis.

B) Humans are its only known host.

C) It is extremely infectious.

D) It cannot be treated with penicillins or cephalosporins.

E) An attenuated vaccine is used for high-risk individuals.

Answer: B



13) Francisella can be transmitted by all of the following EXCEPT

A) a tick bite.

B) direct contact with an infected animal.

C) consumption of infected meat.

D) aerosols produced during animal slaughter.

E) direct contact with an infected person.

Answer: E



14) The causative agent of bubonic and pneumonic plague is

A) Clostridium perfringens.

B) Yersinia pestis.

C) Francisella tularensis.

D) Borrelia burgdorferi.

E) Toxoplasma gondii.

Answer: B



15) Which of the following is characteristic of Yersinia pestis infections?

A) petechiae

B) a “bull’s-eye” rash

C) jaundice

D) arthritis

E) buboes

Answer: E



16) Which of the following is a means by which Borrelia burgdorferi evades the

body’s defenses?

A) It has a polysaccharide capsule.

B) It has manganese-containing enzymes.

C) It is capable of antigenic variation.

D) It has a polysaccharide capsule and antiphagocytic proteins.

E) It is capable of antigenic variation and has manganese-containing enzymes.

Answer: E



17) A bull’s-eye rash is associated with infections of which of the following?

A) Francisella tularensis

B) dengue virus

C) Borrelia burgdorferi

D) Epstein-Barr virus

E) Yersinia pestis

Answer: C



18) Which of the following diseases associated with Epstein-Barr virus is

commonly

seen in AIDS patients?

A) infectious mononucleosis

B) Burkitt’s lymphoma

C) Hodgkin’s lymphoma

D) chronic fatigue syndrome

E) oral hairy leukoplakia

Answer: E


Section: Viral Cardiovascular and Systemic Diseases

19) Epstein-Barr virus infections are typically asymptomatic in which of the

following groups?

A) the elderly

B) AIDS patients

C) adolescents

D) adults

E) young children

Answer: E



20) “Black vomit” is associated with which of the following diseases?

A) malaria

B) dengue fever

C) Chagas’ disease

D) yellow fever

E) schistosomiasis

Answer: D



21) Infection with which of the following species of Plasmodium is most likely to

be

fatal?

A) P. malariae

B) P. vivax

C) P. ovale

D) P. falciparum

E) All of these can cause a fatal infection.

Answer: D


Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases

22) Schizogony is an important aspect of which of the following diseases?

A) plague

B) malaria

C) toxoplasmosis

D) Chagas’ disease

E) schistosomiasis

Answer: B



23) Dengue hemorrhagic fever is actually

A) an immediate immune reaction to the initial infection with dengue virus.

B) an antibody-antigen complex reaction.

C) a hyperimmune response to reinfection with dengue virus.

D) an autoimmune disease.

E) the chronic carrier state associated with dengue virus infection.

Answer: C



24) A young woman develops a fever after a recent trip to a Caribbean island. She

also experiences severe headache and pain “in the bones.” After a few days, she

also

develops a rash. Which of the following did she most likely contract?

A) yellow fever virus

B) dengue virus

C) malaria

D) Toxoplasma

E) Chagas’ disease

Answer: B



25) Which of the following is transmitted by Aedes mosquitoes?

A) dengue fever

B) yellow fever

C) malaria

D) both dengue fever and yellow fever

E) dengue fever, yellow fever, and malaria

Answer: D



26) A large number of people experience a high fever with a rash during the

summer months in a small country. Epidemiologists suspect an emerging disease.

Both Aedes and Anopheles mosquitoes are endemic to the country. Researchers

are

able to detect +ssRNA in the blood of fever victims and in some mosquitoes. What

type of pathogen might be responsible for the epidemic?

A) a herpesvirus

B) a flavivirus

C) Plasmodium

D) plague bacteria

E) a filovirus

Answer: B



27) Which of the following is known to be teratogenic?

A) Epstein-Barr virus

B) cytomegalovirus

C) Plasmodium

D) Borrelia

E) dengue virus

Answer: B



28) Ebola hemorrhagic fever is caused by which of the following virus types?

A) herpesviruses

B) flaviviruses

C) Epstein-Barr viruses

D) filoviruses

E) rhabdoviruses

Answer: D



29) Trypanosoma cruzi is transmitted by which of the following?

A) Triatoma bugs

B) Aedes mosquitoes

C) Ixodes ticks

D) fleas

E) sand flies

Answer: A



30) Which of the following is the infective form of Trypanosoma cruzi?

A) epimastigotes

B) trypomastigotes

C) pseudocysts

D) amastigotes

E) miricidia

Answer: B



31) Historically, physicians have used a procedure called xenodiagnosis to

diagnose

which of the following diseases?

A) malaria

B) toxoplasmosis

C) yellow fever

D) Chagas’ disease

E) schistosomiasis

Answer: D



32) Which of the following diseases is a major problem for AIDS patients?

A) Chagas’ disease

B) toxoplasmosis

C) hemorrhagic fevers

D) Lyme disease

E) brucellosis

Answer: B



33) Which of the following statements concerning Toxoplasma infection is correct?

A) It is a rare infection.

B) It is transmitted by biting insects.

C) It is typically contracted by eating undercooked meat.

D) Freshwater snails are intermediate hosts.

E) In most individuals, the infection results in lasting damage to the heart.

Answer: C



34) Microscopic identification of its spiny eggs is used in the diagnosis of

infections

caused by

A) Schistosoma.

B) Trypanosoma.

C) Toxoplasma.

D) Plasmodium.

E) Borrelia.

Answer: A



35) “Swimmer’s itch” is an initial symptom of which of the following?

A) malaria

B) Lyme disease

C) Chagas’ disease

D) tularemia

E) schistosomiasis

Answer: E



36) Another name for brucellosis is

A) blackwater fever.

B) yellow fever.

C) snail fever.

D) rabbit fever.

E) undulant fever.

Answer: E



37) The normal hosts for Ebola viruses are probably

A) birds.

B) cats.

C) rodents.

D) bats.

E) humans.

Answer: D



38) An indication of infection with Human herpesvirus 4 is

A) “swimmer’s itch.”

B) “bull’s eye” rash.

C) a bubo.

D) high fever and sore throat.

E) an ulcerating sore.

Answer: D



39) Which of the following diseases is currently vaccine-preventable in humans?

A) schistosomiasis

B) malaria

C) Lyme disease

D) plague

E) yellow fever

Answer: E



40) A young man who is an avid outdoorsman goes to see his doctor complaining

of

fever with chills, headache, nausea, and diarrhea. Blood tests show that he has low

levels of leukocytes and platelets. He may have contracted

A) brucellosis.

B) tularemia.

C) Lyme disease.

D) ehrlichiosis.

E) Chagas’ disease.

Answer: D



41) A person reports to a clinic complaining of fever and abdominal pain. The

abdomen is swollen, and blood tests indicate kidney damage. A stool sample is

examined under a microscope and found to contain eggs with a spine projecting

from its surface. The indications are consistent with infection with

A) Plasmodium falciparum.

B) Anaplasma phagocytophilium.

C) Schistosoma mansoni.

D) Toxoplasma gondii.

E) Trypanosoma cruzi.

Answer: C



21.2 True/False Questions

1) Lipid A causes disseminated intravascular coagulation (DIC).

Answer: TRUE



2) Only adult ticks of the genus Ixodes may feed on humans.

Answer: FALSE



3) Small doses of antimicrobial drugs are effective in treatment of the late stages

of Borrelia infection because the microbe is extremely susceptible.

Answer: FALSE



4) The terms “bacteremia” and “septicemia” are synonymous.

Answer: FALSE



5) Patients with occult septicemia are asymptomatic.

Answer: FALSE



6) The three developmental stages of Ehrlichia are the elementary body, the initial

body, and the morula.

Answer: TRUE



7) Human herpesvirus 4 is better known as cytomegalovirus.

Answer: FALSE



8) Neither bubonic nor pneumonic plague can be spread from person to person.

Answer: FALSE



9) Vertical transmission of cytomegalovirus may occur in utero or at the time of

vaginal birth.

Answer: TRUE



10) Episodes of malaria become more and more severe with each recurrence of

symptoms.

Answer: FALSE



21.3 Short Answer Questions

1) The release of bacterial toxins into the blood leads to __________.

Answer: toxemia



2) Bacterial infection of the membrane lining the heart chambers and covering the

valves is called __________.

Answer: endocarditis



3) When bacteria in the bloodstream invade the bones, this leads to a painful

condition called __________.

Answer: osteomyelitis



4) Undulant fever is also known as __________.

Answer: brucellosis



5) Historically, __________ occurred in three great pandemics; the most notable

one

occurred in 14th-century Europe.

Answer: plague



6) One of the factors leading to the initial characterization of Lyme disease in 1975

was the greater-than-expected incidence of __________ among children.

Answer: arthritis



7) Because of their small size, __________ of the tick genus Ixodes most often

transmit

Lyme disease to humans.

Answer: nymphs



8) Epstein-Barr virus causes the cells it infects to become immortal because it

suppresses __________.

Answer: apoptosis



9) Cytomegalovirus infection of the retina is now treated with __________, the

first

antisense RNA drug.

Answer: fomivirsin



10) Yellow fever is named for the jaundice caused by the disease’s damage to the

__________.

Answer: liver



11) The genus __________ includes dengue virus and yellow fever virus. (Be sure

to

use capital letters appropriately.)

Answer: Flavivirus



12) Depletion of clotting proteins from the serum leads to the uncontrollable

hemorrhaging seen in __________ virus and Marburg virus infections. (Be sure to

use

capital letters appropriately.)

Answer: Ebola



13) The sporogonic cycle of __________ takes place entirely within a mosquito.

Answer: malaria



14) Another name for Chagas’ disease is American __________.

Answer: trypanosomiasis



15) True bugs in the genus __________ transmit Chagas’ disease. (Be sure to use

capital

letters appropriately.)

Answer: Triatoma



21.4 Essay Questions

1) Explain the difference between bacteremia and septicemia, and describe some of

the factors that can lead to septicemia.

Answer: Septicemia is a microbial infection of the blood that causes disease.

Although the terms bacteremia and septicemia are sometimes used interchangeably,

bacteremia technically refers to septicemia caused by bacteria in the bloodstream.

The signs and symptoms of bacteremia and septicemia are essentially the same,

and

both can lead to adverse consequences such as toxemia, lymphangitis, or septic

shock. To be able to cause these problems, the bacteria involved in septicemia may

possess capsules, have the ability to capture iron from the host’s tissues, and/or

release a variety of endotoxins that ultimately damage host cells and tissues.



2) Compare and contrast bubonic and pneumonic plague.

Answer: Both bubonic and pneumonic plague are caused by Yersinia pestis and

are

transmitted by fleas that migrate between animal hosts and humans. However,

pneumonic plague is generally much more serious than bubonic plague, develops

more rapidly, and is more often fatal than bubonic plague. In addition, pneumonic

plague can occur when Yersinia pestis is inhaled, so it can be transmitted from

person to person. Bubonic plague is transmitted only by infected fleas. Treatment

and prevention of both diseases are similar: plague is easily treated by common

antibiotics such as tetracycline, and prevention involves rodent and flea control, as

well as good personal hygiene.

Bloom’s Rank: Analysis


3) List and describe the three stages of malaria, paying attention to the various

forms of the protozoan parasite present in each stage of the disease.

Answer: Two of the three stages of malaria occur in a human, and the third stage

occurs in mosquitoes. The human stages begin with the exoerythrocytic cycle,

when

mosquitoes inject sporozoites into the bloodstream. These sporozoites reproduce in

the liver to form merozoites, which are released into the blood. Merozoites then

penetrate red blood cells and launch the second human stage, which is the

erythrocytic cycle. The merozoites become trophozoites inside red blood cells, and

these trophozoites can, in turn, reproduce to become more merozoites, which

spontaneously lyse the erythrocytes, causing the characteristic cycles of fever and

chills associated with malaria. Other merozoites develop into gametocytes, which

can be ingested by the female Anopheles mosquito to launch the third cycle, the

sporogonic cycle. These gametocytes go through a process of sexual reproduction

inside the mosquito, eventually resulting in the formation of sporozoites once again.

These sporozoites migrate to the mosquito’s salivary glands, and the malaria cycle

begins all over again.



4) Compare and contrast dengue hemorrhagic fever and Ebola hemorrhagic fever.

Discuss both the pathogens and the pathology.

Answer: Both diseases are caused by RNA viruses. Both start with fever,

headache

and muscle pain, then a rash develops, followed by bleeding. There is no specific

treatment for either disease and no vaccines are available to prevent them.

Dengue hemorrhagic fever is caused by a member of the Flaviviridae, a +ssRNA

virus

with an icosahedral capsid. It is transmitted by Aedes mosquitoes. A first infection

with dengue virus does not lead to the hemorrhagic disease, but it is subsequent

infection that produces the hemorrhagic disease. Memory T cells produced in

response to the first infection are activated upon subsequent infection and release

inflammatory cytokines that trigger a hyperimmune response that results in

damage to blood vessels, internal bleeding, and may progress to shock from

excessive blood loss.

Ebola viruses are filamentous —ssRNA Filoviridae whose natural hosts are

thought

to be bats. Humans become infected when handling an infected animal, after which

the virus can be transmitted from person to person by unprotected contact with

blood and other bodily fluids. Ebola virus infection initially triggers excessive

clotting which results in depletion of clotting factors, which in turn leads to

extensive internal hemorrhaging. Death results from massive shock and kidney

failure.

Bloom’s Rank: Analysis


5) How does the age of the infected individual play a role in the development of

Epstein-Barr virus (HHV-4) infections such as infectious mononucleosis?

Answer: The symptoms of most Epstein-Barr infections result from a “war”

between the cellular and humoral divisions of the immune system. B cells are

infected by Epstein-Barr virus, and then cytotoxic T cells try to kill the infected B

cells. The younger an infected individual is, the less mature his or her cellular

immune system is, and the less effective it will be in causing symptoms during the

“war.” In fact, in young children, Epstein-Barr virus infections are usually

asymptomatic. The later in life an individual is infected with Epstein-Barr virus,

the

more vigorous the cellular immune system is, and the more problematic and

symptomatic the infection becomes. On the other hand, however, a vigorous

cellular

immune response also means that the infected B cells may be completely

eradicated

from the body, resulting in no discernible disease in many individuals.



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