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Test Bank for Microbiology with Diseases by Body System 3rd Edition by Bauman 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 2) Whole blood with the formed elements and clotting proteins removed is called A) plasma B) lymph C) serum D) CSF E) axenic Answer: C Bloom’s Rank: Knowledge Section: Structure of the Cardiovascular System 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 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 5) Infection of the lymphatic vessels is known as A) disseminated intravascular coagulation B) bacteremia C) lymphangitis D) petechiae E) recurrent fever Answer: C Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 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 Section: Bacterial Cardiovascular and Systemic Diseases 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 Section: Bacterial Cardiovascular and Systemic Diseases 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 Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Comprehension Section: Bacterial Cardiovascular and Systemic Diseases 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 Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 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 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 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 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 Section: Viral Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 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 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 Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Application Section: Viral Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Application Section: Viral Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 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 Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 30) Which of the following is the infective form of Trypanosoma cruzi? A) epimastigotes B) trypomastigotes C) pseudocysts D) amastigotes E) miricidia Answer: B Bloom’s Rank: Knowledge Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 36) Another name for brucellosis is A) blackwater fever B) yellow fever C) snail fever D) rabbit fever E) undulant fever Answer: E Section: Bacterial Cardiovascular and Systemic Diseases 37) The normal hosts for Ebola viruses are probably A) birds B) cats C) rodents D) bats E) humans Answer: D Section: Viral Cardiovascular and Systemic Diseases 38) An indication of infection with Human herpesvirus 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 Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Application Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Application Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 21.2 True/False Questions 1) Lipid A causes disseminated intravascular coagulation (DIC) Answer: TRUE Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 2) Only adult ticks of the genus Ixodes may feed on humans Answer: FALSE Bloom’s Rank: Comprehension Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Comprehension Section: Bacterial Cardiovascular and Systemic Diseases 4) The terms “bacteremia” and “septicemia” are synonymous Answer: FALSE Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 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 7) Human herpesvirus 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 Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 10) Episodes of malaria become more and more severe with each recurrence of symptoms Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 3) When bacteria in the bloodstream invade the bones, this leads to a painful condition called 4) Undulant fever is also known as Answer: brucellosis Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 5) Historically, occurred in three great pandemics; the most notable one occurred in 14th-century Europe Answer: plague Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Comprehension Section: Bacterial Cardiovascular and Systemic Diseases 7) Because of their small size, of the tick genus Ixodes most often transmit Lyme disease to humans Answer: nymphs Bloom’s Rank: Knowledge Section: Bacterial Cardiovascular and Systemic Diseases 8) Epstein-Barr virus causes the cells it infects to become immortal because it suppresses Answer: apoptosis Bloom’s Rank: Comprehension Section: Viral Cardiovascular and Systemic Diseases 9) Cytomegalovirus infection of the retina is now treated with , the first antisense RNA drug Answer: fomivirsin Bloom’s Rank: Comprehension Section: Viral Cardiovascular and Systemic Diseases 10) Yellow fever is named for the jaundice caused by the disease’s damage to the Answer: liver Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 11) The genus includes dengue virus and yellow fever virus (Be sure to use capital letters appropriately.) Answer: Flavivirus Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Knowledge Section: Viral Cardiovascular and Systemic Diseases 13) The sporogonic cycle of takes place entirely within a mosquito Answer: malaria Bloom’s Rank: Comprehension Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 14) Another name for Chagas’ disease is American Answer: trypanosomiasis Bloom’s Rank: Knowledge Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 15) True bugs in the genus transmit Chagas’ disease (Be sure to use capital letters appropriately.) Answer: Triatoma Bloom’s Rank: Knowledge Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Comprehension Section: Bacterial Cardiovascular and Systemic Diseases 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 Section: Bacterial Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Comprehension Section: Protozoan and Helminthic Cardiovascular and Systemic Diseases 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 Section: Viral Cardiovascular and Systemic Diseases 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 Bloom’s Rank: Comprehension Section: Viral Cardiovascular and Systemic Diseases