Which of the following pairs is mismatched?
A. Haemophilus influenzae – virulence due to capsule
B. Naegleria fowleri – causes amoebic meningoencephalitis
C. Mycobacterium leprae – grows in armadillos
D. Cryptococcus neoformans – acid-fast rod
E. Neisseria meningitidis – produces deadly endotoxins

D. Cryptococcus neoformans – acid-fast rod

All of the following organisms are correctly matched to the recommended treatment EXCEPT
A. Cryptococcus neoformans – amphotericin B.
B. poliovirus – amphotericin B.
C. Mycobacterium leprae – dapsone.
D. Neisseria meningitidis – cephalosporins.
C. Haemophilus influenzae – cephalosporins.

B. poliovirus – amphotericin B.

Which of the following statements about leprosy is FALSE?
A. It is transmitted by direct contact.
B. Patients with leprosy must be isolated.
C. Diagnosis is based on skin biopsy.
D. It is rarely fatal.
E. The etiologic agent is acid-fast.

B. Patients with leprosy must be isolated.

All of the following organisms are transmitted via the respiratory route EXCEPT
A. Haemophilus influenzae.
B. Cryptococcus neoformans.
C. Neisseria meningitidis.
D. Listeria monocytogenes.
E. None of the answers is correct; all of these organisms are transmitted by the respiratory route.

D. Listeria monocytogenes.

Which of the following statements about rabies is FALSE?
A. Average incubation period is 30 to 50 days after initial infection.
B. Most infections in the U.S. are the result of bites from infected dogs.
C. It is caused by Lyssavirus.
D. Hydrophobia is associated with the disease.
E. Diagnosis is based on immunofluorescent techniques.

B. Most infections in the U.S. are the result of bites from infected dogs.

The symptoms of tetanus are due to
A. tetanospasmin.
B. systemic infection.
C. inflammation.
D. endospore formation.
E. sustained relaxation of muscles.

A. tetanospasmin.

All of the following diseases are caused by arbovirus EXCEPT
A. primary amebic meningoencephalitis (PAM).
B. St. Louis encephalitis.
C. West Nile encephalitis.
D. eastern equine encephalitis.
E. None of the answers is correct; all of these diseases are caused by arbovirus.

A. primary amebic meningoencephalitis (PAM).

A 30-year-old woman was hospitalized after she experienced convulsions. On examination, she was alert and oriented and complained of a fever, headache, and stiff neck. Any of the following organisms could be responsible for her symptoms EXCEPT
A. Streptococcus pneumoniae.
B. Clostridium botulinum.
C. Listeria monocytogenes.
D. Haemophilus influenza.
E. Any of these organisms could be the causative agent.

B. Clostridium botulinum.

The most effective control of mosquito-borne disease is
A. treatment of infected wild animals.
B. elimination of the mosquito population.
C. treatment of infected humans.
D. treatment of uninfected humans.
E. avoidance of endemic areas.

B. elimination of the mosquito population.

Initial treatment for tetanus in an unimmunized person with a puncture wound is
A. tetanus toxoid.
B. none; no action is necessary.
C. debridement.
D. penicillin.
E. tetanus immune globulin.

E. tetanus immune globulin.

Initial treatment for tetanus in a fully immunized person with a puncture wound is
A. debridement.
B. penicillin.
C. tetanus toxoid (inactivated tetanus toxin) booster.
D. tetanus immune globulin.
E. supportive rehydration therapy.

C. tetanus toxoid (inactivated tetanus toxin) booster.

The most common route of central nervous system invasion by pathogens is through
A. direct penetration into nerves.
B. the gastrointestinal system.
C. the circulatory system.
D. the parenteral route.
E. the skin.

C. the circulatory system.

The prodromal (i.e., pre-acute disease stage) symptoms of bacterial meningitis are
A. fever, headache, and stiff neck.
B. mild cold symptoms.
C. fever and headache.
D. stiff neck and back pains.
E. convulsions.

B. mild cold symptoms.

All of the following are associated with botulism outbreaks EXCEPT
A. Alaskan natives have the lowest rate of botulism in the world.
B. type E toxin is associated with seafood.
C. endospores of C. botulinum have been recovered from honey.
D. type A toxin is most virulent.
E. antibodies are not an effective method of treatment.

A. Alaskan natives have the lowest rate of botulism in the world.

A pathologist detects Negri bodies while examining a brain section taken at autopsy. What was the cause of death?
A. rabies
B. eastern equine encephalitis
C. poliomyelitis
D. Hansen's disease
E. meningococcal meningitis

A. rabies

Encephalitis is more common in the summer months because
A. people encounter more bats during warm summer evenings.
B. pathogens are present in swimming pools and lakes.
C. mosquito populations increase.
D. ameba populations increase in swimming pools.
E. ticks are encountered while hiking in the woods.

C. mosquito populations increase.

Which of the following pairs is mismatched?
A. leprosy – direct contact
B. rabies – direct contact
C. meningococcal meningitis – respiratory route
D. listeriosis – ingestion
E. poliomyelitis – respiratory route

E. poliomyelitis – respiratory route

A 30-year-old woman was hospitalized after she experienced convulsions. On examination, she was alert and oriented and complained of a fever, headache, and stiff neck. Which of the following is most likely to provide rapid identification of the cause of her symptoms?
A. check serum antibodies
B. Gram stain of throat culture
C. Gram stain of cerebrospinal fluid
D. biopsy of brain tissue
E. None of these would provide rapid identification.

C. Gram stain of cerebrospinal fluid

Each of the following is caused by prions EXCEPT
A. Creutzfeldt-Jakob disease.
B. kuru.
C. bovine spongiform encephalopathy.
D. rabies.
E. sheep scrapie.

D. rabies.

Which of the following vaccine characteristics is (are) mismatched with their respective vaccine type?

Salk Vaccine Sabin Vaccine
1. Consists of a formalin-inactivated 4. Consists of a live, virus attenuated polio virus 2. Administered orally 5. Administered orally
3. Requires booster doses 6. Provides community immunity

A. 1 and 3 only
B. 4, 5, and 6
C. 2 only
D. 1, 3, and 5
E. None of the answers are correct; all these characteristics are correctly matched.

C. 2 only

An eight-year-old girl in rural Wisconsin has chills, headache, and fever and reports having been bitten by mosquitoes. How would you confirm your diagnosis of arboviral encephalitis?
A. examination of local mosquitoes
B. ELISA test for IgM antibodies
C. brain biopsy for Negri bodies
D. complement fixation test for IgG antibodies
E. Gram stain of cerebrospinal fluid

B. ELISA test for IgM antibodies

All of the following are true of chronic fatigue syndrome EXCEPT
A. it is a psychological disorder.
B. it may have a genetic component.
C. it may be triggered by a viral infection.
D. it is also known as myalgic encephalomyelitis.
E. it often begins with flu-like symptoms that do not go away.

A. it is a psychological disorder.

A physician diagnoses a patient with lepromatous Hansen's disease. All of the following pertain to the patient EXCEPT
A. infection probably occurred as a result of prolonged contact with another infected individual.
B. disfiguring nodules form all over the body.
C. the disease has progressed from the tuberculoid stage.
D. treatment will include injections of penicillin.
E. a skin biopsy will be taken to aid diagnosis.

D. treatment will include injections of penicillin.

Arboviruses cause ________ and are transmitted by ________.
A. meningitis; bee stings
B. encephalitis; dog bites
C. meningitis; mosquitoes
D. encephalitis; mosquitoes
E. both meningitis and encephalitis; mosquitoes

D. encephalitis; mosquitoes

Naegleria fowleri meningoencephalitis is commonly acquired by
A. ingestion of water contaminated with fecal material.
B. swimming in warm ponds or streams.
C. exposure to bird droppings.
D. mosquito bites.
E. exposure to body fluids of a contaminated individual.

B. swimming in warm ponds or streams.

Diagnosis of rabies is confirmed by
A. patient's symptoms.
B. passive agglutination.
C. patient's death.
D. direct fluorescent-antibody test.
E. Gram stain.

D. direct fluorescent-antibody test.

Which of the following is treated with antibiotics?
A. botulism
B. polio
C. streptococcal pneumonia
D. tetanus
E. All of these diseases can be successfully treated with antibiotics.

C. streptococcal pneumonia

Which one of the following causes the most severe illness in humans, with a mortality rate of 30 percent?
A. West Nile encephalitis
B. eastern equine encephalitis
C. western equine encephalitis
D. St. Louis encephalitis
E. California encephalitis

B. eastern equine encephalitis

Which of the following is/are a free-living amoeba that can cause encephalitis?
A. Naegleria
B. Entamoeba and Naegleria
C. Naegleria and Acanthamoeba
D. Entamoeba
E. Acanthamoeba

C. Naegleria and Acanthamoeba

Microscopic examination of cerebrospinal fluid reveals gram-positive rods. What is the organism?
A. Neisseria
B. Naegleria
C. Listeria
D. Streptococcus
E. Haemophilus

C. Listeria

On June 30, a 47-year-old man was hospitalized with dizziness, blurred vision, slurred speech, difficulty swallowing, and nausea. Examination revealed facial paralysis. He reported eating home-canned green beans and stew containing roast beef and potatoes 24 hours before onset of symptoms. The patient should be treated with
A. toxin.
B. vaccination.
C. supportive care, including respiratory assistance.
D. antibiotics.
E. surgery.

C. supportive care, including respiratory assistance.

On October 5, a pet store sold a kitten that subsequently died. On October 22, rabies was diagnosed in the kitten. Between September 19 and October 23, the pet store had sold 34 kittens. Approximately 1000 people responded to health care providers following local media alerts. These people were given
A. antiviral medications.
B. antibiotics.
C. immune globulin injections.
D. human diploid cell vaccine.
E. postexposure prophylaxis.

E. postexposure prophylaxis.

Vaccination is available for all the following EXCEPT
A. tetanus.
B. Neisseria meningitis.
C. Haemophilus meningitis.
D. rabies.
E. botulism.

E. botulism.

Patients with leprosy usually die from complications such as
A. cardiac arrest.
B. loss of nerve function.
C. brain damage.
D. tuberculosis.
E. pneumonia.

D. tuberculosis.

All of the following are acquired by ingestion EXCEPT
A. cryptococcosis.
B. botulism.
C. listeriosis.
D. Creutzfeldt-Jakob disease.
E. poliomyelitis.

A. cryptococcosis.

A one-year-old boy was listless, irritable, and sleepy. Encapsulated Gram-negative rods were cultured from his cerebrospinal fluid. His symptoms were caused by
A. Neisseria meningitidis.
B. Clostridium tetani.
C. rabies.
D. Haemophilus influenzae.
E. a prion.

D. Haemophilus influenzae.

Which of the following pairs is mismatched?
A. tetanus – releases potent neurotoxin
B. poliomyelitis – multiplication of virus occurs in throat and small intestine
C. botulism – stimulates transmission of nerve impulse
D. leprosy – deformation of nose and hands can occur
E. rabies virus – destroys cells of the CNS

C. botulism – stimulates transmission of nerve impulse

All of the following microorganisms can directly cause meningitis EXCEPT
A. mosquitoes.
B. bacteria.
C. virus.
D. protozoa.
E. fungi.

A. mosquitoes.

Which of the following vaccines can cause the disease it is designed to prevent?
A. inactivated polio vaccine
B. Haemophilus influenzae capsule vaccine
C. tetanus toxoid vaccine
D. oral polio vaccine
E. meningococcal capsule vaccine

D. oral polio vaccine

All of the following are true of M. leprae EXCEPT
A. it invades cells of the PNS.
B. it has a very short generation time of approximately twelve hours.
C. it grows best at temperatures below 37°C.
D. it survives ingestion by macrophages.
E. it can be cultured in armadillos.

B. it has a very short generation time of approximately twelve hours.

All of the following are true of poliomyelitis EXCEPT
A. the oral polio vaccine contains attenuated strains of the virus.
B. infection is due to ingestion of contaminated water.
C. initial sites of viral replication are the throat and small intestine.
D. most cases result in muscle paralysis.
E. the majority of cases are asymptomatic.

D. most cases result in muscle paralysis.

Which one of the following diseases may cause a polio-like paralysis in older adults?
A. Bell's palsy
B. West Nile virus infection
C. chronic fatigue syndrome
D. cryptococcosis

B. West Nile virus infection

Which one of the following statements about West Nile virus is FALSE?
A. The disease is maintained in a bird-mosquito-bird cycle.
B. The disease is maintained in a horse-human-horse cycle.
C. Most human cases are subclinical or mild.
D. The disease caused by the virus can sometimes cause a fatal encephalitis.
E. The virus was introduced to the United States in 1999 in the New York City area.

B. The disease is maintained in a horse-human-horse cycle.

Which one of the following diseases causes symptoms in fewer than 1% of infected individuals, but has a mortality rate in symptomatic patients of about 20%?
A. Eastern equine encephalitis
B. West Nile virus encephalitis
C. California encephalitis
D. Western equine encephalitis
E. St. Louis encephalitis

E. St. Louis encephalitis

Which one of the following statements on Zika virus is FALSE?
A. It is transmitted primarily through the bite of infected Aedes spp. Mosquitoes.
B. It causes temporary and self-resolving facial muscle paralysis.
C. It is a member of the Flaviviridae.
D. The virus was first discovered in 1947 in the Zika forest in Uganda.
E. It greatly increases the risks of a fetus developing microcephaly if the mother contracts the virus while pregnant.

B. It causes temporary and self-resolving facial muscle paralysis.

Which disease listed below, results in symptoms of a drooping eyelid or mouth on one side of the face, and is caused when a facial muscle nerve becomes inflamed?
A. St. Louis encephalitis
B. chronic fatigue syndrome
C. Bell's palsy
D. Eastern equine encephalitis
E. bovine spongiform encephalopathy

C. Bell's palsy