HLTB21H3 Final: Exam Study Guide - Leprosy, Tuberculosis, Syphilis

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26 Feb 2011

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320bc records in ancient greece, after army of alexander the great returned from. 62bc - rome returned with pompeii"s troops from asia minor. Thought to be hereditary illness, caused by a curse or punishment of god. Lepers were stigmatized special clothing, arrival notification, separate hospitals, leprosariums/lazaretto/leper colony/lazar house. mid-12th century loss of civic status removal from public office; discovers the leprosy germ under a microscope. Average doubling time of 12 14 days. Thought to be transmitted via droplets, from the nose during close and frequent contact. not highly infectious may be related to genetic susceptibility. mainly affects the skin, nerves, and mucous membranes. Risk common in warm, wet areas in the tropics and subtropics; most susceptible between the ages of 10 and 14 years old, 35-44 years old. who recommends multidrug therapy (mdt) dapsone, rifampicin, clofazimine promin (1941) www. notesolution. com. do not develop human type leprosy, usually more severe and fatal;

Related Questions

Highlight or bold the answer you select for multiple choice or type in your answer in the blank space provided.

1. Which of the following is not true of the nervous system?

Consists of central and peripheral systems

(b) Central nervous system is composed of brain and spinal cord

(d) Meninges are membranes that cover brain and spinal cord

(e) Normally free of microbes

2. Which of the following is a common cause of meningitis in nonimmunized young children?

(a) Streptococcus pneumoniae

(b) Escherichia coli

(d) Haemophilus influenzae

(e) None of the above

3. A complication of infection with this organism (Waterhouse-Friderichsen syndrome) can occur if the organism becomes widely distributed in the body, leading to endotoxin shock and death. The organism is:

(a) Haemophilus influenzae type A

(b) Neisseria meningitidis

(d) Streptococcus pneumoniae

(e) Listeria monocytogenes

4. Which of the following bacterial meningitis diseases currently is the most common type in the U.S., with increased incidences in infants and in the 15- to 24-year-old age group, and has three types or strains of the infectious microbe?

(a) Haemophilus meningitis

(b) Listeriosis

(d) Meningococcal meningitis

(e) a and c

5. Before development of a vaccine against this microbe, the disease it caused accounted for two-thirds of bacterial meningitis cases during the first year of life but is still the number one leading cause of mental retardation in patients who survive serious disease due to permanent central nervous system disorders. What is the microorganism?

(a) Haemophilus influenzae type B

(b) Haemophilus influenzae type A

(d) Streptococcus pneumoniae

(e) Listeria monocytogenes

6. Which of the following bacteria that may cause meningitis is Gram-positive and therefore does not cause endotoxin shock in infected individuals?

(a) Escherichia coli

(b) Neisseria meningitidis

(d) Haemophilus influenzae type B

(e) None of these

7. Avid swimmers and hot tub enthusiasts sometimes acquire an opportunistic infection caused by Naegleria fowleri that results in a meningoencephalitis. This organism is a (an):

(a) Protist

(b) Helminth

(d) Amoeba

(e) a and d

8. Which of the following in NOT true about listeriosis?

(a) Foodborne transmission is the most common source of infection.

(b) It is a leading cause of bacterial meningitis today.

(d) It is sometimes acquired as a zoonosis.

(e) Individuals with impaired immune systems are highly susceptible to this disease.

9. Viral meningitis is usually always fatal if untreated, unlike bacterial meningitis, which is always self-limiting and nonfatal. True or false?

10. Which of the following is acid-fast and causes Hansen's disease?

(a) Mycobacterium tuberculosis

(b) Clostridium tetani

(d) Haemophilus influenzae

(e) Mycobacterium leprae

11. An immunofluorescent antibody test (IFAT) has replaced the older test for the presence of inclusions in neurons (Negri bodies) for the detection of infections caused by:

(a) Neisseria meningitidis

(b) Enteroviruses

(d) Rabies virus

(e) Haemophilus influenza

12. The viruses that cause encephalitis are most likely to be:

(a) Togaviruses

(b) Enteroviruses

(d) Rabies virus

(e) Hepatitis viruses

13. What do the following viral encephalitis diseases have in common: eastern equine encephalitis, western equine encephalitis, Venezuelan equine encephalitis, St. Louis encephalitis, West Nile fever?

(a) They are all caused by the same virus.

(b) They are have the horse as a common intermediate host.

(d) Birds are never involved in the life cycle of the viruses that cause these diseases.

(e) Both a and d.

14. The only bacterium known to damage peripheral nerves is:

(a) Naegleria fowleri

(b) Mycobacterium leprae

(d) Neisseria meningitidis

(e) Haemophilus influenzae

15. All of the following are true about Clostridium tetani, the causative agent of tetanus, EXCEPT:

(a) They are spore-forming rods.

(b) They are part of the normal bowel microflora of horses, cattle, and humans.

(d) Their toxin elicits muscle stiffness, spasms, and paralysis in the victim.

(e) They require oxygen to survive.

16. A vaccine that was developed in 1933 has proven effective in reducing the incidence of disease caused by:

(a) Clostridium botulinum

(b) Mycobacterium leprae

(d) Streptococcus pneumoniae

(e) Listeria monocytogenes

17. The most common form of disease caused by Clostridium botulinum is:

(a) Infant

(b) Wound

(d) Foodborne

(e) None of these

18. The endospores of this organism are the most heat-resistant known; it is:

(a) Clostridium tetani

(b) Clostridium botulinum

(d) Streptococcus thermicos

(e) Listeria monocytogenes

19. All of the following are true about Clostridium botulinum, the causative agent of botulism, EXCEPT:

(a) Their ability to form toxin depends on infection with a bacteriophage.

(b) They can produce one of eight different toxins, all of which cause human disease.

(d) Although their endospores are highly heat-resistant, their toxin can be inactivated by only a few minutes' boiling.

(e) All of the above are true.

20. All of the following are true about poliomyelitis EXCEPT:

(a) Most poliovirus infections are inapparent or mild and nonparalytic.

(b) Polio can be caused by three strains of picornaviruses.

(c) The Salk vaccine contains live, attenuated polioviruses while the Sabin vaccine contains formalin-inactivated polioviruses.

(d) Transmission is by the fecal-oral route and pharyngeal secretions.

(e) Poliomyelitis has afflicted man for thousands of years.

graydinosaur157

44.Charlotte touches a doorknob after an individual with MRSA touched the doorknob. Immediately after touching the knob, Charlotte scratches her leg and transmits some MRSA cells into a small wound.The doorknob is functioning as a(n) a. etiologic agent. c. mode of transmission. b. reservoir. d. host. 44.A man infected with a viral respiratory infection sneezes and releases tiny droplets containing viral particles. Two minutes later, a woman breathes in some of these tiny droplets and becomes infected by the same viral infection. The movement of this virus from one individual to another is best described as the a. etiologic agent. c. mode of transmission. b. reservoir. d. host. 45. Although sporadic outbreaks of measles occur in the United States, the disease is considered nonendemic. What differentiates measles from endemic diseases, such as chickenpox? a. Endemic diseases exhibit higher numbers of cases than a sporadic outbreak. b. Diseases that are not endemic lack a reservoir in the area. c. Endemic diseases do not exhibit sporadic outbreaks. d. Diseases that are not endemic remain in reservoirs without infecting humans. 46. Which of the following would indicate efforts to control a disease are working? a. The disease becomes endemic. b. The disease prevalence increases. c. The disease incidence decreases. d. Outbreaks of the disease only occur every other year. 47. Which of the following statements describes one of the three steps of surveillance used for infectious diseases? a. Patients with infectious diseases are required to be seen by a physician at the CDC. b. Physicians are required to submit all patient records electronically to the CDC for review. c. Patient charts are reviewed by an infection control practitioner when an infectious disease is suspected. d. Incidence data is collected in all cases of bacterial infections within the United States. 48. Which of the following lists correctly identifies nosocomial infections from most common to least common? a. urinary tract, pneumonia, septicemia b. pneumonia, urinary tract, surgical wounds c. septicemia, surgical wounds, diarrhea d. diarrhea, urinary tract, pneumonia 49. Mary, an elderly woman with an indwelling catheter, is admitted to a local hospital for treatment of pneumonia. Three days after her admission, Maryâs husband receives a call from the hospital. He is informed that Mary has a nosocomial infection. Which of the following statements is true? a. The nosocomial infection referred to is pneumonia. b. Mary has most likely developed a urinary tract infection. c. Of all hospital patients, 25â30% develop nosocomial infections. d. Maryâs nosocomial infection could have been prevented with improved ventilation. 50. A nurse working in a large hospital harbors MRSA as part of the normal microbiota in his nose. He is most likely the source of a MRSA outbreak if a. infected patients have all had been cared for by this nurse and the isolates are identical. b. the patients are all elderly and the isolates of MRSA are not genetically identical. c. all of the infected patients were seen by the same physician and half of the patients were cared for by this nurse. d. all of the infected patients are on the same floor of the hospital and all have a history of heart problems. 51. Which of the following is NOT an example of aseptic technique? a. use of antiseptic on skin prior to insertion of an IV line b. use of latex gloves during the insertion of an indwelling catheter c. disinfection of doorknobs and other inert surfaces d. use of trash can liners in all patient rooms 52. An individual case of diphtheria, a notifiable infectious disease, in a patient in Florida is confirmed by laboratory testing. This patientâs physician would be required to a. send a letter to the WHO in Geneva, Switzerland. b. contact the CDC in Atlanta, Georgia. c. treat the patient regardless of health insurance status. d. quarantine the patient for eight weeks. 53. Fifteen individuals within one province in China are diagnosed with SARS. Epidemiologists will most likely a. quarantine the entire province immediately. b. contact the CDC in the United States to see if any cases were reported in the United States. c. wait to see if more cases of SARS are reported. d. try to identify the index case. 54. How does vaccinating wild rodents or poultry influence human health? a. Vaccinating wild rodents or poultry has no effect on human health. b. Vaccinating wild rodents or poultry reduces transmission of zoonotic diseases to humans. c. Vaccinating wild rodents or poultry reduces the migration of microbes into temperate regions. d. Vaccinating wild rodents or poultry increases the emergence of drug-resistant bacteria. 55. Which of the following scenarios would help meet the goal of the One Health Initiative? a. vaccinating poultry against avian influenza to prevent influenza from being transmitted to humans b. taking steps to reduce carbon dioxide emissions to reduce the effects of climate change c. providing sanitation after flooding events to prevent gastrointestinal infections in humans d. increasing compliance during antibiotic treatment of tuberculosis patients to prevent emergence of drug-resistant strains of tuberculosis 56. If humans continue to develop rapid transportation systems into more parts of the world, we should expect to see a. pandemics tracing the path of the transportation systems. b. an increase in detection of blood-borne pathogens. c. a decrease in human encroachment into tropical rain forests. d. an increase in the spread of transmissible spongiform encephalopathies. 57. How has the AIDS pandemic influenced reemerging diseases? a. AIDS has increased the number of immunocompromised individuals who are susceptible to diseases that were previously declining in developed countries. b. AIDS has led to an increase in the number of disease vectors throughout the world. c. AIDS has increased the prevalence of protozoal and parasitic infections that were declining in underdeveloped countries. d. AIDS has caused evolution to occur in diseases that were close to being eradicated in all countries. 58. Which of the following is likely to occur as a result of climate change? a. Insect vectors will migrate from tropical regions to once-temperate regions. b. Gastrointestinal infections will decrease in tropical regions. c. Microbes currently found in temperate regions will move to tropical regions. d. Extreme weather will decrease and diseases will become less seasonal. 59. What features would allow a virus to be used effectively as a bioweapon? a. a high infectious dose c. person-to-person transmission b. transmission via an insect vector d. quick pathogen detection systems

Investigation of Possible Bioterrorism-Related Activity

Patient History:

A 38-year-old woman who resided in the Northeast was admitted to the hospital with fever, myalgia, and weakness, which progressed over 3 days to respiratory failure requiring mechanical ventilation. On day 22, after 3 weeks of intensive care, the patient was still febrile. Cultures of blood were negative.

Hospital personnel interviewed family members who reported no history of traditional risk factors for fever of unknown origin (e.g., relevant food, infected animal contact, or travel history). On day 24, the patient's family reported to hospital personnel that the patient's illness might have been caused by exposure to laboratory flasks and cultures kept in her apartment by her boyfriend. He was described as a foreign national studying biology, but recently he had returned to his country of citizenship. On day 25, the patient's family brought laboratory flasks, Petri dishes, and culture media to the hospital from the patient's apartment. Several contained an unidentified clear liquid. The patientâs unresponsiveness and the acknowledged potential for some bacterial species to be used as bioterrorist agents raised concerns among the infection control staff that this case might be associated with a bioterrorist event or unintentional exposure to contaminated materials in the patient's home. The hospital contacted local law enforcement, the Department of Public Health, and the Federal Bureau of Investigation about the unusual circumstances surrounding the case.

On day 30, under the authority of state communicable disease statutes and in cooperation with the local police department, fire department, and hazardous materials unit, NHDHHS personnel entered the patient's apartment to assess any possibility of an ongoing public health hazard. Remaining flasks were removed and cultured. After 48 hours, growth of a translucent, pinpoint, and smooth colony appeared on blood agar and chocolate agar.

Gram stain of the colonies revealed faintly staining Gram-negative rods that were catalase positive, oxidase positive, and rapidly urea positive. On day 33, the patient began to get better after extensive antibiotic therapy.

Early detection is essential to ensure a prompt response to a biological terrorist event. Local public health authorities must rely on clinicians to recognize and report suspicious or unusual presentations of disease. However, correlating suspicious cases originating from diverse locations or discerning an increase in common presentations above the normal baseline is difficult. As in this case, public health practitioners coordinating disease surveillance may be able to receive reports of rare diseases and to determine whether they are occurring at a higher than normal rate in a large surveillance area.

The CDC, in collaboration with local, state, and territorial health departments, is enhancing existing disease surveillance systems for specific diseases that are normally rare in the United States but thought to have a high potential for public health impact if used as biological terrorism agents. This is being accomplished by improving training of clinical, laboratory, and public health personnel in recognizing suspicious disease presentations and by expanding of existing, disease-specific surveillance infrastructure. In addition, surveillance is being improved for disease presentations, such as acute respiratory distress, hemorrhagic, or meningeal symptoms normally caused by common infectious agents, but that could indicate an increase in illnesses caused by a biological agent used in terrorism. Surveillance mechanisms to rapidly assess changes in rates of disease include monitoring of calls to local emergency medical systems, regularly reviewing emergency department discharge diagnoses, and linking infection control practitioner networks.

Assignment:

For this case study, write a 1-page report that describes the possible agent of bioterrorism along with pathogenesis, treatment, and prevention. Include a brief discussion of sentinel labs and their role in recognizing potential episodes of bioterrorism.

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HLTB21H3 Final: Exam Study Guide - Leprosy, Tuberculosis, Syphilis

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