CH-20 Test Review PDF

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1.

Award:

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After a Drug Enforcement Agency raid on a location that housed intravenous drug users, several were brought to the hospital with rapid breathing, fever, and an altered mental state. Which of the following statements is correct?

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Many drug users are HIV-positive, so the patients should all be monitored for levels of CD4 T-cells before any other action is taken. A broad-spectrum antibiotic is needed promptly, as they are likely to be in septic shock from intravenous introduction of microbes into the blood.

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Unsanitary conditions in the house probably resulted in infestations with insects, so it's prudent to examine them for insect bites that may provide a clue.

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Stained blood smears should be performed promptly to look for abnormalities in the blood cells.

Section: 20.03

2.

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Epidemiologists classify diseases by their mortality rate (the percent of infected individuals who die from the disease) and by their communicability (how easy it is to transmit the disease). Which of the following diseases of the cardiovascular system is mismatched with a description of its properties?

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Plague; somewhat high mortality rate and low communicability

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AIDS; high mortality rate and low communicability

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Ebola; high mortality rate and high communicability Malaria;low mortality rate and high communicability

Section: 20.03

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3.

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Which of the following infectious agents and means of disposal are mismatched?

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Drums made with animalhides should be treated with sterilizing gas to eliminate endospores.

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Coagulation factors purified from blood must be heat-treated to destroy HIV.

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Carcasses of animals that died of anthrax must be incinerated to avoid endospores entering the soil.

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Mosquito bed nets must be washed in bleach weekly to eliminate any residual Plasmodium.

Section: 20.03

4.

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Several infections of the cardiovascular system can be identified by inspecting a stained blood smear in the microscope. For the following infections, identify the microscope observation that does not fit the disease.

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Chagas disease; protozoan visible amongblood cells Epstein-Barr virus; virus visible inside red blood cells

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Babesiosis; protozoan visible inside red blood cells

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Malaria; ring trophozoites visible inside red blood cells

Section: 20.03

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5.

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Despite the aggressive defense of the cardiovascular system by the immune system, some microbes can invade and establish an infection in the blood. From the following list of microbes and their virulence factors, identify the mismatch.

 Borrelia burgdorferichanges its surface antigens to avoid immune recognition.   Bacillus anthracisproduces antioxidants to combat lysosomes.  Coxiella burnetiiproduces an endospore-like structure.  Trypanosoma cruzi cloaks itself in host proteins to avoid immune recognition.

Section: 20.01

6.

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Section: 20.03 

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Endocarditis is often a consequence of bacteria attached to the heart valves. These microbes are not eliminated by circulating lymphocytes because _______.

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Gram-positive microbes don't have an exotoxin surface molecule to trigger an immune response

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lymphocytes do not circulate through the heart valves to detect the presence of microbes

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lymphocytes cannot engulf microbes attached to tissue

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these microbes become covered in platelets and fibrin which is not recognized as foreign by the immune system

Section: 20.01

Section: 20.03

7.

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The heart wall has three layers. In order from the outer layer to the inner layer, they are ______.

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endocardium, myocardium, and epicardium

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myocardium,endocardium, and epicardium

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endocardium,epicardium, and myocardium

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epicardium, myocardium, and endocardium

Section: 20.01

8.

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Under normal healthy circumstances, the lymphatic system filters any microorganisms present.

 

True False

Section: 20.01

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9.

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Which of the following statements regarding the structure of blood vessels is incorrect?

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Blood vessels are often found in parallel with lymphatic vessels.

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Capillaries have only a single layer of endothelium, rendering them fragile and leaky during an infection with a hemorrhagic fever virus.

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Connective tissue and muscle fibers are found in the layers of tissue surrounding both arteries and veins.

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In contrast to veins, arteries have higher blood pressure, more tissue layers, and are thinner vessels.

Section: 20.01

10.

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Section: 20.03

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Hemorrhagic and nonhemorrhagic fever diseases have a common feature of a high fever. These categories of diseases are distinguished by _______.

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the pattern of the fever, whether it is constant or varies with time

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viral causes in hemorrhagic fevers and bacterial or protozoan causes in nonhemorrhagic fevers

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the viral load in the blood, specifically the viral titer

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the integrity of the capillary endothelium and its ability to contain the blood the overall mortality rate, as hemorrhagic fevers have a much higher mortality rate

Section: 20.03

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11.

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The fibrous sac that encloses the heart is the ______.

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myocardium

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epicardium

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ectocardium

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endocardium

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pericardium

Section: 20.01

12.

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The cardiovascular system is highly protected from microbial infection because _______.

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failure to do so will result in a systemic infection

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it is the only body system that has no normal microbiota

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it is the only body system that is liquid-based, i.e., with blood

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it is so close to the skin that even minor injuries could lead to major infection

Section: 20.01

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13.

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The most important defense of the cardiovascular system against infection is ______.

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the blood-brain barrier

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lymph nodes

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lymphocytes in the blood fever

Section: 20.01

14.

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The presence of viruses in the blood is called ______.

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viremia

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hemovirus

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fungemia

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septicemia

Section: 20.02

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15.

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When bacteria flourish and grow in the blood stream, the condition is termed ______.

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fungemia

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bactocarditis

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sepsis viremia

Section: 20.03

16.

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Which of the following statementsis incorrect regarding subacute endocarditis?

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Bacteria colonize previously damaged heart tissue resulting in biofilm growth. It is caused by autoantibodies that inappropriately target heart and valve tissue.

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It can be caused by oral bacteria that are introduced to the bloodby dental procedures.

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It occurs exclusively in patients that have prior heart damage.

Section: 20.03

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17.

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The cardiovascular and lymphatic systems have no normal biota.

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True False

Section: 20.02

18.

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Your patient was admitted for a gunshot wound about a week ago. As a precautionary activity, the doctor placed her on antibiotics for a few days while recuperating. Blood specimens are drawn on the patient a several times daily and sent to the microbiology lab for analysis of bacteria. Nothing has grown in culture. On her 4th day in the hospital, she has had no fever and no other signs of infection, but one set of blood specimens has been reported positive for a bacterium. The culture was identified by the lab as Staphylococcus epidermidis, a common organism on the skin. Predict the likely situation leading to this.

 Staphylococcus epidermidis is a very slow growing bacterium and was probably in the blood right after the gunshot wound, but failed to grow until now.

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The patient is immunodepressed and very susceptible to bacterial infection.

  Staphylococcus epidermidis isa skin contaminant that ended up in the blood specimen as a consequence of poor aseptic technique during the venipuncture.

 Staphylococcus epidermidis has converted to a pathogen because of the antibiotics prescribed for the patient.

Section: 20.02

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19.

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Most cases of sepsis are caused by ______.

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viruses bacteria

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prions

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protozoans

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fungi

Section: 20.03

20.

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Anthrax is ______.

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a zoonosis

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transmitted by contact, inhalation, or ingestion

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a disease that, in humans, can cause a rapidly fatal toxemia and septicemia

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only seen sporadically in the United States

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All of the choices are correct.

Section: 20.03

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21.

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Which of the following statements regardingBacillus anthracis is incorrect?

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It is a gram-positive bacillus.

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A capsule and exotoxins are virulence factors.

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Its reservoir includes grazing animals and soil.

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It grows primarily under anaerobic conditions.

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It is capable of formingendospores.

Section: 20.03

22.

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Which of the following is incorrect regarding Yersinia pestis?

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It is a gram-negative rod.

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It has a capsule as a virulence factor.

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It produces coagulase as a virulence factor.

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It produces anenterotoxin. It exhibits bipolar staining and appears to resemble a safety pin.

Section: 20.03

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23.

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Control of rodent populations is important for preventing ______.

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brucellosis



plague

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Q fever

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malaria

Section: 20.03

24.

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Award:

The causative organism of malaria is a ______.

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bacterium

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prion

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virus

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protozoan fungus

Section: 20.03

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25.

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The most common causative agent of acute endocarditis is ______.

  Staphylococcus aureus  Streptococcus pneumoniae  Neisseria gonorrhoeae 

Epstein-Barrvirus

 Streptococcus pyogenes

Section: 20.03

26.

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Acute endocarditis is most commonly contracted through ______.

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parenteral entry

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droplets

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fomites

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casual contact

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ingestion

Section: 20.03

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27.

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

Yersinia pestis _______.

 

was virulent historically but currently circulating strains are not virulent is usually transmitted by a flea vector

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has deer as an endemic reservoir

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does not respond to antimicrobial drugs

Section: 20.03

28.

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Which of the following is not true of bubonic plague?

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A patient exhibits fever, headache, nausea, and weakness. It is transmitted by the fecal-oral route.

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An infection can progress to septicemia.

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It is caused by Yersinia pestis.

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A patient often has enlarged inguinal lymph nodes.

Section: 20.03

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29.

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Plague exhibits a _______.

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septic form historically called the Black Death

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bubonic form in which swollen lesions termed buboes develop

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pneumonic form that manifests as a respiratory disease

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All of the choices are correct.

Section: 20.03

30.

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Award:

Bubonic plague is transmitted by ______.

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fomites

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rats

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sexual contact

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mosquitoes



fleas

Section: 20.03

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31.

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Award:

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Which of the following is not true of tularemia?

 

Its symptoms include fever, swollen lymph nodes, ulcerative lesions, conjunctivitis, and pneumonia. The causative agent is a gram-positive bacterium.

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It is transmitted by arthropod vectors.

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It is sometimes called rabbit fever.

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It is a zoonosis.

Section: 20.03

32.

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Award:

Rabbits and rodents are the chief reservoirs of the causative agent of ______.

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Lyme disease



plague



brucellosis



mononucleosis



tularemia

Section: 20.03

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33.

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The causative agent of Lyme disease is ______.

  Borrelia burgdorferi  Borrelia hermsii  Ixodes pacificus  Ixodes scapularis  Leptospira interrogans

Section: 20.03

34.

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Award:

Erythema migrans, a bull's-eye rash, at the site of a tick bite is associated with ______.



Lyme disease



Rocky Mountain spotted fever

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Q fever

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plague



ehrlichiosis

Section: 20.03

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35.

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The white-footed mouse, deer, and deer ticks are important to maintaining the zoonotic transmission cycle associated with ______.



plague



Rocky Mountain spotted fever



babesiosis

 

Lyme disease Q fever

Section: 20.03

36.

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Award:

Lyme disease is transmitted by ______.



flies



fleas



droplets



lice



ticks

Section: 20.03

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37.

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

Which of the following statements regarding the Epstein-Barr virus is incorrect?



An infection typically requires hospitalization for about a week.

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An infection results in sudden leukocytosis.

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The virus is transmitted by direct oral contact and saliva.

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The virus has a 30-50 day incubation period.

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Transmission has been documented through contaminated blood transfusions and organ transplants.

Section: 20.03

38.

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

Symptoms of infectious mononucleosis include _______.

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fever and pocks on skin

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fever, severe diarrhea, pneumonitis, hepatitis, and retinitis

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vesicular lesions in oral mucosa



sore throat, fever, cervical lymphadenopathy, and splenomegaly

Section: 20.03

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39.

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The preferred treatment for anthrax is ______.

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quinine



penicillin



decided after consultation with the CDC

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the Bio-Thrax vaccine

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ciprofloxacin

Section: 20.03

40.

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Award:

A common cardiovascular/lymphatic system disease in AIDS patients is ______.



Burkitt's lymphoma



cytomegalovirus



acute endocarditis



brucellosis



ehrlichiosis

Section: 20.03

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41.

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Plague is a quarantinable disease.

 

True False

Section: 20.03

42.

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Lyme disease is only seen in people living in Lyme, Connecticut.

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True False

Section: 20.03

43.

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Award:

Humans should be routinely vaccinated against Lyme disease.

 

True False

Section: 20.03

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44.

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Your 49-year-old mother has just been diagnosed with subacute endocarditis with the ...