Test Bank Chapter 18 Infectious Cardio-Lymph Diseases

Microbiology Fundamentals: A Clinical Approach, 3e (Cowan)

Chapter 18 Infectious Diseases Affecting the Cardiovascular and Lymphatic Systems

1) The fibrous sac that encloses the heart is the ________.

A) epicardium

B) myocardium

C) endocardium

D) pericardium

E) ectocardium

2) The presence of viruses in the blood is called ________.

A) viremia

B) fungemia

C) hemovirus

D) bacteremia

E) septicemia

3) ________ occurs when bacteria flourish and grow in the bloodstream.

A) Viremia

B) Fungemia

C) Hemovirus

D) Bacteremia

E) Septicemia

4) 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

5) The common causative agent of acute endocarditis is ________.

A) Staphylococcus aureus

B) Streptococcus pneumoniae

C) Streptococcus pyogenes

D) Neisseria gonorrhoeae

E) All of the choices are correct.

6) Acute endocarditis is most commonly contracted through ________.

A) ingestion

B) parenteral entry

C) casual contact

D) droplets

E) fomites

7) Most cases of septicemia are caused by ________.

A) fungi

B) viruses

C) prions

D) bacteria

E) protozoans

8) Which of the following is not true of septicemia?

A) Fever and shaking chills

B) Respiratory acidosis

C) Endotoxic shock

D) Parenteral or endogenous transfer

E) Drop in blood pressure

9) Yersinia pestis ________.

A) was virulent in the Middle Ages but is no longer virulent

B) has humans as an endemic reservoir

C) does not respond to antimicrobial drugs

D) is usually transmitted by a flea vector

E) All of the choices are correct.

10) All of the following are associated with bubonic plague except ________.

A) transmitted by human feces

B) caused by Yersinia pestis

C) patient often has enlarged inguinal lymph nodes

D) patient has fever, headache, nausea, and weakness

E) can progress to a septicemia

11) 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

12) 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.

13) Bubonic plague is transmitted by ________.

A) mosquitos

B) flies

C) animal bites

D) sexual contact

E) fleas

14) Control of rodent populations is important for preventing ________.

A) brucellosis

B) plague

C) malaria

D) Q fever

E) All of the choices are correct.

15) Which is not associated with tularemia?

A) A zoonosis

B) Mammals are the chief reservoir

C) A gram-positive bacterium

D) Symptoms include fever, swollen lymph nodes, ulcerative lesions, conjunctivitis, and pneumonia

E) Sometimes called rabbit fever

16) Rabbits and other rodents are the reservoirs of the causative agent of ________.

A) tularemia

B) anthrax

C) malaria

D) brucellosis

E) mononucleosis

17) The causative agent of Lyme disease is ________.

A) Ixodes scapularis

B) Borrelia hermsii

C) Borrelia burgdorferi

D) Ixodes pacificus

E) Leptospira interrogans

18) Erythema migrans, a bull's-eye rash, at the portal of entry is associated with ________.

A) plague

B) Rocky Mountain spotted fever

C) Q fever

D) Lyme disease

E) yellow fever

19) The white-footed mouse, deer, and deer ticks are important to maintaining the transmission cycle associated with ________.

A) Lyme disease

B) yellow fever

C) Q fever

D) Rocky Mountain spotted fever

E) plague

20) 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.

21) Lyme disease is transmitted by ________.

A) flies

B) droplets

C) lice

D) fleas

E) ticks

22) Epstein-Barr virus has the following characteristics except it ________.

A) is more commonly found in adults

B) is transmitted by direct oral contact and saliva

C) produces sudden leukocytosis

D) has a 30- to 50-day incubation

E) can be transmitted by contaminated blood transfusions and organ transplants

23) Symptoms of infectious mononucleosis include ________.

A) vesicular lesions in oral mucosa

B) fever and pocks on skin

C) sore throat, fever, cervical lymphadenopathy, and splenomegaly

D) fever, severe diarrhea, pneumonitis, hepatitis, and retinitis

E) None of the choices are correct.

24) Which of the following requires direct contact with infected body fluids?

A) Yellow fever

B) Dengue fever

C) Ehrlichiosis

D) Lassa fever

E) Chikungunya

25) Which of the following is a hemorrhagic fever?

A) Yellow fever

B) Ehrlichiosis

C) Q fever

D) Rocky Mountain spotted fever

E) None of the choices are correct.

26) 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.

27) Which of the following is not true of Ebola and Marburg?

A) Caused by filoviruses

B) Disruption of clotting factors

C) Transmitted by direct contact with body fluids

D) Transmitted by mosquitoes

E) There is no treatment for these viruses

28) Which type of hemorrhagic fever can be treated with ribavirin?

A) Lassa fever

B) Ebola

C) Marburg

D) Dengue fever

E) Yellow fever

29) Which type of hemorrhagic fever is also known as "breakbone fever" because of the severe pain in bones?

A) Lassa fever

B) Ebola

C) Marburg

D) Dengue fever

E) Yellow fever

30) The reservoir for Lassa fever is the ________.

A) monkey

B) rat

C) gorilla

D) cat

E) cattle

31) 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 who work with animals

E) All of the choices are correct.

32) Pasteurization of milk helps to prevent ________.

A) tularemia

B) plague

C) endocarditis

D) brucellosis

E) mononucleosis

33) The gram-negative bacillus associated with abscesses from cat bites or scratches is ________.

A) Salmonella typhimurium

B) Yersinia enterocolitica

C) Bartonella henselae

D) Brucella suis

E) Francisella tularensis

34) Rocky Mountain spotted fever ________.

A) is seen in highest numbers along the west coast

B) is transmitted by Ixodes ticks

C) symptoms include fever, headache, and rash

D) never has severe complications

E) All of the choices are correct.

35) Which is incorrect regarding Q fever?

A) Transmitted by lice

B) Pathogen produces resistant spores

C) Humans infected from unpasteurized milk and airborne spread

D) Causes fever, muscle aches, rash, and sometimes pneumonia

E) Is a zoonosis

36) Which of the following is mismatched?

A) Yersinia pestis—plague

B) Coxiella burnetii—Q fever

C) Brucellosis melitensis—undulating fever

D) Bartonella henselae—cat-scratch disease

E) Rickettsia typhi—Rocky Mountain spotted fever

37) Cat-scratch fever can be prevented by ________.

A) avoiding ticks

B) pasteurizing milk

C) vaccine

D) animal control

E) cleaning the scratch wound

38) The symptoms that occur in cyclic 48- to 72- hour episodes in a malaria patient are ________.

A) bloody, mucus-filled stools, fever, diarrhea, and weight loss

B) fever, swollen lymph nodes, and joint pain

C) urinary frequency and pain, and vaginal discharge

D) chills, fever, and sweating

E) sore throat, low-grade fever, and swollen lymph nodes

39) Which is incorrect about malaria?

A) Merozoites enter and multiply in liver cells.

B) Trophozoites develop in RBCs.

C) The mosquito inoculates human blood with sporozoites.

D) Gametocytes enter the mosquito as she draws a blood meal from a human.

E) Cerebral malaria is a potential serious complication.

40) The cyclic bouts of fever and chills in malaria are caused by ________.

A) liver cell lysis

B) white blood cell lysis

C) red blood cell lysis

D) neurological involvement

E) None of the choices are correct.

41) 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.

42) The causative organism of malaria is a ________.

A) bacterium

B) virus

C) fungus

D) protozoan

E) prion

43) Characteristics of Bacillus anthracis include all the following except ________.

A) capsule and exotoxins are virulence factors

B) a one-time vaccine provides lifelong immunity

C) reservoir includes infected grazing animals and contaminated soil

D) gram-positive bacillus

E) spore former

44) 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.

45) A common cardiovascular/lymph system disease in AIDS patients is ________.

A) acute endocarditis

B) Burkitt's lymphoma

C) herpes simplex virus

D) ehrlichioses

E) brucellosis

46) Retroviruses have the following characteristics except ________.

A) glycoprotein spikes

B) DNA genome

C) enveloped

D) reverse transcriptase

E) viral genes integrate into the host genome

47) All of the following pertain to patients with AIDS except they ________.

A) have an immunodeficiency

B) have CD4 T-cell titers below 200 cells/mm3 of blood

C) get repeated, life-threatening opportunistic infections

D) can get unusual cancers and neurological disorders

E) have the highest number of cases worldwide in the United States

48) Documented transmission of HIV involves ________.

A) mosquitoes

B) unprotected sexual intercourse and contact with blood/blood products

C) respiratory droplets

D) contaminated food

E) All of the choices are correct.

49) 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

50) Which drugs interfere with the action of an HIV enzyme needed for final assembly and maturation of the virus?

A) Reverse transcriptase inhibitors

B) Protease inhibitors

C) Fusion inhibitors

D) Integrase inhibitors

E) All of the choices are correct.

51) Which new class of drugs will interfere with docking onto host cells?

A) Reverse transcriptase inhibitors

B) Protease inhibitors

C) Fusion inhibitors

D) Integrase inhibitors

E) All of the choices are correct.

52) A frequent cancer that is seen in AIDS patients is ________.

A) leukemia

B) Hodgkin's lymphoma

C) Kaposi's sarcoma

D) melanoma

E) myeloma

53) The cardiovascular and lymphatic systems have limited or no normal biota.

54) Plague is a zoonotic disease.

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

56) A vaccine for Lyme disease is available.

57) Aedes mosquitoes are the vectors involved in yellow fever and dengue fever.

58) 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.

59) The highest numbers of cases of Rocky Mountain spotted fever occur along the eastern seaboard.

60) Rifampin is the drug of choice for malaria.

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

62) The cardiovascular and lymphatic systems are both circulatory in nature.

63) Which of the statements is incorrect regarding the similarities and differences between the cardiovascular and lymphatic systems?

A) Although the cardiovascular and lymphatic systems run virtually parallel to each other, blood and lymphatic fluid never mixes.

B) Both the cardiovascular system and the lymphatic system comprise a series of vessels that run roughly parallel to each other.

C) The cardiovascular system is a closed circuit, whereas the lymphatic system directs fluid in one direction only.

D) The cardiovascular system has a pump (the heart) to circulate blood, whereas the lymphatic system has no pumping mechanism.

64) While the cardiovascular system can be breached by microorganisms, mechanisms are in place to prevent infection.  These include ________.

A) a close association with the lymphatic system which screens and filters the blood

B) blood vessels that are impermeable to microorganisms

C) toxic chemicals that will kill any microbes that enter the bloodstream

D) a connective tissue fibrous mesh that filters the blood within the vessels, preventing pathogens from circulating

65) The lymphatic system is a major defense system in the body; it renders surveillance, recognition, and protection against foreign materials through a system of lymphocytes, phagocytes, and antibodies.

66) Since the cardiovascular and lymphatic systems are not directly accessible to microbes ________.

A) it was initially believed that the systems lacked normal biota, however the Human Microbiome Project suggests that low levels of microbes may exist in the healthy state

B) both systems are sterile in the healthy state

C) the abundant microbiota enter via the gastrointestinal tract then cross the blood vessels

D) the Human Microbiome Project confirmed that only pathogens exist in both systems

67) Due to the efficiency of the lymphatic system and the inaccessibility to microbes, data from the Human Microbiome Project confirmed that the cardiovascular system lacks microbiota in the healthy state.

68) Which of the following statements is true concerning the epidemiology of malaria?

A) Malaria transmission is restricted to an area encompassing the equator, largely due to control of mosquito populations.

B) Malaria is an endemic disease throughout the world.

C) The majority of new malaria cases each year are in South America.

D) The elderly are the most at risk population for death from malaria.

69) Which of the following statements is false concerning the epidemiology of malaria?

A) Malaria has been eradicated from the United States.

B) The majority of malaria cases are restricted to a band encompassing the equator.

C) Africa sees the highest incidence of malaria in the world.

D) Children and young adults are the most at-risk population for malaria.

70) Of the 200 million new cases of malaria each year, 10% are in areas that roughly span the equator outside of the African continent.

71) Which of the following is true regarding HIV cases in the United States?

A) HIV in the United States represents approximately 3.2% of cases worldwide.

B) The % of new HIV cases is increasing each year.

C) The majority of newly-diagnosed cases in 2015 were in the Latino population.

D) Heterosexual transmission of HIV is decreasing in the United States.

72) Nowadays, HIV is more of a chronic disease than the death sentence it was when it first emerged in the 1980s.  In addition to lifesaving medications, education and testing has also lowered the number of new cases annually. This means that in general ________.

A) incidence is decreasing and prevalence is increasing

B) prevalence is decreasing and incidence is increasing

C) incidence and prevalence are both increasing

D) incidence and prevalence are both decreasing

73) The greatest rise in new HIV infections throughout the world is in the homosexual male population.

74) Bacillus anthracis exhibits characteristics that make it a model organism to be exploited as an agent of bioterrorism.  Those characteristics include ________.

A) the ability to form endospores, allowing it to be stored for long periods of time without nutrients or water

B) the ability to infect and cause disease in several body systems including the lungs, cardiovascular system and gastrointestinal tract

C) the ability to produce a tripartite toxin and polypeptide capsule as virulence factors

D) difficulty diagnosing and therefore treating because the manifestations mimic other, more common diseases

E) All of the choices reflect characteristics that make B. anthracis a candidate for bioterrorism.

75) Anthrax is easy to diagnose and treat because the manifestations are localized to a single tissue and specific in nature.

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A nurse is volunteering with a medical team in Southeast Asia. A 35-year-old female presents to the clinic reporting that the village doctors have diagnosed her with malaria. The nurse notes that the woman is febrile, tachypneic, and her eyes have a yellow tint. She reports generalized body aches and weakness.  Through a translator, the nurse collects the woman's medical history. She reports feeling ill for about ten days, experiencing several cycles of fever, sweating, and chills that are temporarily relieved before occurring again. The village doctors treated her with a combination of a mosquito paste and an indigenous root, but her symptoms have not improved. The medical team performs serological testing at the clinic and confirms a diagnosis of malaria.

76) What is the cause of the cyclical nature of the woman's symptoms?  

A) She is being reinfected by a vector as she begins to recover.

B) The village doctor's treatments are working intermittently.

C) Her symptoms reflect the synchronous rupture of RBCs.

D) Her liver is failing in stages, and the symptoms coincide.

77) If the medical team had the ability to perform more thorough blood tests, what would the nurse expect to find?  

A) Hyperglycemia, increased RBC count

B) Hyperglycemia, decreased RBC count

C) Hypoglycemia, increased RBC count

D) Hypoglycemia, decreased RBC count

78) Which of the following medications would the nurse expect to be ordered for this patient?  

A) Chloroquine

B) Vancomycin

C) Artemisinin

D) Acyclovir

79) If pharmacological treatment is not successful, what may be the ultimate cause of death?

A) Malaremia

B) Multiorgan failure

C) Seizures

D) Respiratory arrest

80) The nurse provides education to the woman's family regarding malaria prevention. All of the following are recommended, except ________.

A) washing all bedding and clothing in hot water

B) eliminating areas of stagnant water

C) use of bed nets

D) prophylactic antimalarials

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A pregnant 25-year-old woman with known HIV infection presents to an obstetric office for a 20-week prenatal visit. This is her first pregnancy and thus far it has been uncomplicated. The patient was first diagnosed as HIV-positive seven years prior and she has remained asymptomatic. She has been compliant with her antiretroviral therapies. The patient reports that the father of her child is not HIV-positive.

81) The patient asks the nurse what the risk is of her child being HIV-positive. What is the best response by the nurse? 

A) The child will be HIV-positive and there is no way to prevent transmission.

B) Since HIV is passed through the father, the child will be HIV negative.

C) It is possible that HIV will be passed on to your child, but you can decrease the likelihood of transmission by compliance with antiretroviral therapy.

D) Fetal immunity will ward off HIV during pregnancy, but the child should not breastfeed.

82) The patient states that she acquired HIV from a previous partner. What are the primary modes of HIV transmission?  

A) Saliva and blood

B) Sexual contact and blood

C) Sexual contact and body fluids

D) Blood and other body fluids

83) What is the most successful treatment during pregnancy to reduce transmission of HIV from mother to fetus?  

A) Pre-exposure prophylaxis

B) Protease inhibitors

C) Reverse transcriptase inhibitors

D) Fusion inhibitors

84) When should the patient's newborn baby be tested for HIV, assuming she does not breastfeed?

A) At birth

B) 1 month of age

C) At birth and 1 month of age

D) Every 6 months for 3 years

85) The patient asks the nurse for information about preventing HIV transmission to her sexual partner. What is the best form of prevention for HIV transmission, assuming sexual abstinence is not an option?  

A) Use of barrier-method contraceptive

B) Contraceptive drugs

C) Prophylactic treatment of all sexual partners with antiviral chemotherapy

D) compliance with antiretroviral regimen

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A 13-year-old girl with cerebral palsy is admitted to the pediatric surgical unit following a posterior spinal fusion. During the procedure, rods were implanted to straighten her spine. Per the orthopedic surgical team's report, the patient tolerated the procedure well. Her post-operative vital signs were stable. 24 hours after she arrives to the inpatient unit, her blood pressure is 70/35, heart rate is 150 beats per minute, temperature is 104°F, and respiratory rate is 30 breaths per minute. She is difficult to arouse and is not responding to questions. The nurse calls for emergent assistance. Upon removing the dressing, it is noted that her incision is swollen, red, and oozing a cloudy white substance.

86) Which of the following is the most likely cause of the acute change in the patient's status? 

A) Localized infection

B) Bacterial septicemia

C) Postoperative hemorrhagic fever

D) Fungemia

87) What is the most likely cause of septicemia?  

A) Gram-positive bacteria

B) Gram-negative bacteria

C) Gram-positive and gram-negative bacteria

D) Fungus

88) The medical team suspects that the patient has septicemia. Boluses of isotonic fluid are given and vasoactive medications are ordered to increase her blood pressure. Which of the following are the most important next interventions?

A) Respiratory support, blood cultures, and antibiotics

B) Wound cleansing, antipyretics, and antibiotics

C) Maintenance intravenous fluids, blood cultures, and antibiotics

D) Respiratory support, wound cleansing, and antipyretics

89) Preliminary testing on the blood cultures reveals the presence of gram-positive cocci. Although the final organism has not been identified, which of the following organisms is the most likely cause of the patient's septicemia?

A) Staphylococcus aureus

B) Streptococcus pneumoniae

C) Haemophilus influenzae

D) Neisseria gonorrhoeae

90) When the final results of the blood culture return three days later, the patient is diagnosed with S. aureus septicemia. Empiric antibiotic therapy was initiated with her initial clinical decompensation. What is the next step in the patient's treatment regimen?  

A) Continue initial empiric therapy as cessation could encourage resistance

B) Change antibiotic coverage as indicated by susceptibility testing

C) Discontinue antibiotics as three days of treatment is standard

D) Continue empiric coverage until clinical symptoms improve