OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections | LATEST UPDATE

T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 1 of 17 Chapter 26: Nervous System Infections * = Correct answer Multiple Choice 1. Which of the following is the innermost membrane surrounding the brain? A. arachnoid mater B. dura mater C. pia mater* D. ventricle mater Difficulty: Easy ASM Standard: N/A 2. Which term describes tingling or numbness in peripheral nerves? A. neuralgia B. neurological deficit C. neuropathy* D. neurotaxis Difficulty: Easy ASM Standard: N/A 3. Which part of a neuron releases neurotransmitters? A. the dendrites B. the myelin sheath C. the synapse D. the synaptic terminals* Difficulty: Easy ASM Standard: N/A 4. Which of the following terms describes inflammation of the membranes surrounding the brain? A. cephalic tetanus B. encephalitis C. meningitis* D. neuritis Difficulty: Easy ASM Standard: N/A 5. Before enrolling in college, students are encouraged to undergo vaccination for which of the following diseases? A. botulism B. candidiasis TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 2 of 17 C. listeriosis D. meningococcal meningitis* Difficulty: Easy ASM Standard: 23 6. Hansen’s disease is more commonly known as which of the following? A. leprosy* B. pneumococcal meningitis C. poliomyelitis D. tetanus Difficulty: Easy ASM Standard: 23 7. Which of the following is an example of a transmissible spongiform encephalopathy? A. chronic wasting disease* B. St. Louis encephalitis C. tetanus D. Zika virus Difficulty: Easy ASM Standard: N/A 8. Which term describes a nervous system infection caused by a fungus? A. bacillary infection B. dermatomycosis C. neuromycosis* D. transmissible spongiform encephalopathy Difficulty: Easy ASM Standard: 23 9. Human African trypanosomiasis is transmitted by which of the following? A. contaminated water B. mosquitoes C. ticks D. tsetse flies* Difficulty: Easy ASM Standard: 23 10. Schwann cells serve a function similar to that of oligodendrites, but, unlike oligodendrites, they are located in which part of the nervous system? A. brain B. central nervous system TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 3 of 17 C. peripheral nervous system* D. spinal cord Difficulty: Moderate ASM Standard: N/A 11. Which of the following describes the difference between a glial cell and a neuron? A. Neurons are white matter and glial cells are gray matter. B. Neurons conduct impulses and glial cells have supportive roles.* C. Only neurons are technically nervous tissue. D. Only neurons can contribute to myelination. Difficulty: Moderate ASM Standard: N/A 12. A lumbar puncture (spinal tap) reveals the presence of leukocytes in the cerebrospinal fluid. This finding most likely indicates which of the following? A. an adverse medication reaction B. head trauma C. infectious meningitis or encephalitis* D. leukemia Difficulty: Moderate ASM Standard: 23 13. Which of the following is not a common cause of bacterial meningitis? A. Haemophilus influenzae B. Neisseria meningitidis C. Staphylococcus aureus* D. Streptococcus pneumoniae Difficulty: Moderate ASM Standard: 23 14. Which fungal pathogen causes brain abscesses, rather than meningitis? A. Aspergillus fumigatus B. Candida albicans C. Coccidioides immitis D. Rhizopus arrhizus* Difficulty: Moderate ASM Standard: 23 15. Which of the following is the most common outcome of Cryptococcus neoformans infection? A. granuloma formation B. meningitis TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 4 of 17 C. pneumonia D. subclinical respiratory infection* Difficulty: Moderate ASM Standard: 23 16. Which of the following describes the role of the thick capsule of Cryptococcus neoformans? A. It facilitates movement across the blood-brain barrier. B. It inhibits clearance by phagocytosis.* C. It is involved in cell entry. D. It triggers hypersensitivity reactions. Difficulty: Moderate ASM Standard: 23 17. Which of the following statements about antifungal medications is false? A. They are generally used at low doses. B. They can only be administered short term.* C. They do not easily cross the blood-brain barrier. D. They often have strong side effects. Difficulty: Moderate ASM Standard: 14, 23 18. When histoplasmosis causes meningitis, in which way does the pathogen reach the brain? A. directly from the external environment B. from the external environment via the olfactory nerve C. through dissemination from a respiratory infection* D. through dissemination from a skin infection Difficulty: Moderate ASM Standard: 23 19. Naegleria fowleri is most common in which of the following habitats? A. cold mountain lakes B. northern rivers C. the ocean D. warm bodies of freshwater* Difficulty: Moderate ASM Standard: 23 20. Which form of Naegleria fowerli causes primary amoebic encephalitis? A. cyst B. endospore C. merozoite TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 5 of 17 D. trophozoite* Difficulty: Moderate ASM Standard: 23 21. Amoebic keratitis is caused by: A. Acanthamoeba and Balamuthia* B. Acanthamoeba and Naegleria C. Balamuthia and Entamoeba D. Naegleria and Entamoeba Difficulty: Moderate ASM Standard: 23 22. Which of the following is a sign or symptom of Winterbottom’s? A. a central nervous system lesion in individuals with rabies B. an indication of meningitis C. lymph node enlargement associated with trypanosomiasis* D. septicemia associated with vector-borne illness Difficulty: Moderate ASM Standard: 23 23. Trypanosomiasis is generally diagnosed using which of the following? A. clinical signs and symptoms only B. microscopy* C. nucleic acid testing D. serologic testing Difficulty: Moderate ASM Standard: 6, 23 24. Which of the following is one of the most common parasitic causes of brain abscesses in immunocompromised patients? A. Naegleria fowleri B. Taenia solium C. Toxoplasma gondii* D. Trypanosoma brucei Difficulty: Moderate ASM Standard: 23 25. Which of the following is usually diagnosed via imaging? A. African trypanosomiasis B. arboviral encephalitis C. neurocysticercosis* TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 6 of 17 D. rabies Difficulty: Moderate ASM Standard: 23 26. With which of the following is rabies treated upon exposure? A. rabies immune globulin B. rabies vaccination C. rabies immune globulin and vaccination* D. supportive therapy only Difficulty: Moderate ASM Standard: 14, 23 27. Transmissible spongiform encephalopathies are caused by which agent? A. acellular particles that resemble viruses B. particles consisting of genetic material with no outer covering C. prions that resemble normal proteins and lack nucleic acid* D. subcellular particles with proteins and DNA Difficulty: Moderate ASM Standard: N/A 28. Meningitis can cause which of the following? A. abnormal glucose levels in the CSF B. abnormal protein levels in the CSF C. leukocytes in the CSF D. leukocytes and abnormal glucose and protein levels in the CSF* Difficulty: Moderate ASM Standard: 23 29. For how long should cryptococcal infections in non-HIV–infected individuals be treated with amphotericin B and flucytosine? A. a few days B. about a week C. at least 10 days D. at least 10 weeks* Difficulty: Difficult ASM Standard: 14, 23 30. Which animals are the most common reservoirs for rabies? A. birds, mice, and goats B. cats, dogs, and horses C. opossums, skunks, and feral cats TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 7 of 17 D. raccoons, bats, skunks, and foxes* Difficulty: Difficult ASM Standard: 23 31. Which of the following causes the symptoms of rabies? A. Brain cells are destroyed. B. Hydrophobia results in dehydration. C. Neurotransmitter function is disrupted in the brain.* D. Peripheral nerves are killed throughout the body. Difficulty: Difficult ASM Standard: 23 32. Which of the following is the natural reservoir for West Nile Virus? A. birds* B. humans C. mosquitoes D. raccoons Difficulty: Moderate ASM Standard: 23 33. Which of the following is not true of Hansen’s disease? A. It is caused by Mycobacterium leprae. B. It is highly contagious.* C. It may be transmitted by armadillos. D. Many humans have natural immunity. Difficulty: Difficult ASM Standard: 23 34. Demyelination is an important component of infection by which of the following? A. Clostridium tetani B. Listeria monocytogenes C. Mycobacterium leprae* D. Neisseria meningitidis Difficulty: Difficult ASM Standard: 23 35. Listeria monocytogenes is able to penetrate the intestinal wall and blood-brain barrier because of which of the following? A. a capsule B. internalins* C. neurotoxins TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 8 of 17 D. small size Difficulty: Difficult ASM Standard: 23 True/False 36. Neuropathy is caused solely by pathogens. Answer: False Difficulty: Easy ASM Standard: 23 37. Rabies cannot be diagnosed in humans before death because diagnosis requires direct examination of central nervous system tissue. Answer: False Difficulty: Easy ASM Standard: 23 38. Meningitis can be caused by pathogens or by noninfectious means. Answer: True Difficulty: Moderate ASM Standard: 23 39. Rabies is always fatal once symptoms begin to appear. Answer: False Difficulty: Moderate ASM Standard: 23 40. If someone is bitten by a wild animal that escapes, it is better to wait to confirm a case of rabies through laboratory testing rather than begin treatment as soon as it is suspected. Answer: False Difficulty: Moderate ASM Standard: 23 41. Pulsed-field gel electrophoresis is used to distinguish Listeria monocytogenes subtypes. Answer: True Difficulty: Moderate ASM Standard: 23 42. Meningococcal meningitis can result in limb amputation. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 9 of 17 Answer: True Difficulty: Difficult ASM Standard: 23 43. Botulism is caused by the release of tetanus toxin in spoiled food. Answer: False Difficulty: Difficult ASM Standard: 23 Matching 44. Match each structure with its best definition. A. axon i. the main body of a neuron, containing the nucleus and most of the cell’s organelles B. dendrites ii. the long extension of a neuron through which an action potential travels to transmit a signal C. myelin sheath iii. a gap into which neurotransmitters are released to transmit chemical signals from one cell to another D. soma iv. a finely branched extension from a neuron that picks up incoming impulses E. synapse v. an insulated covering produced by oligodendrites or Schwann cells that speeds the conduction of nervous impulses Answers: A. ii., B. iv., C. v., D. i., E. iii. Difficulty: Easy ASM Standard: N/A 45. Match each vaccine with its best description. A. DTaP i. protects against a type of meningitis B. Hib vaccine ii. a killed virus vaccine that protects against polio C. Sabin vaccine iii. protects against tetanus and two other bacterial infections D. Salk vaccine iv. an attenuated virus vaccine that protects against polio Answers: A. iii., B. i., C. iv., D. ii. Difficulty: Moderate ASM Standard: 14, 23 46. Match each type of meningitis with its best description. A. Cryptococcus meningitis i. generally relatively mild compared with other types of meningitis; caused by a variety of pathogens B. Haemophilus influenzae type B meningitis ii. can cause a petechial rash and is of particular concern for college students C. meningococcal meningitis iii. the causative agent is gram positive and lancet shaped TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 10 of 17 D. pneumococcal meningitis iv. caused by a fungus E. viral meningitis v. treated with doxycycline, fluoroquinolones, cephalosporins, or carbapenems Answers: A. iv., B. v., C. ii., D. iii., E. i. Difficulty: Moderate ASM Standard: 23 47. Match each disease with its best description. A. aspergillosis i. bacterial disease B. kuru ii. viral disease C. leprosy iii. protozoal disease D. PAM iv. fungal disease E. poliomyelitis v. prion disease Answers: A. iv., B. v., C. i., D. iii., E. ii. Difficulty: Moderate ASM Standard: 23 48. Match each disease with its best diagnostic protocol. A. Creutzfeldt-Jakob disease i. evaluation of clinical presentation; serologic testing of serum or CSF B. cryptococcosis ii. evaluation of clinical presentation, acid-fast staining, and microscopy of skin biopsy specimens or smears C. eastern equine encephalitis iii. evaluation of clinical symptoms and new specific virus RNA assay, RT-PCR testing, and MAC-ELISA testing D. Hansen’s disease iv. histological examination of brain biopsy specimens E. Zika virus v. lumbar puncture with negative CSF stain and routine culture Answers: A. iv., B. v., C. i., D. ii., E. iii. Difficulty: Moderate ASM Standard: 23 49. Match each virus with the best description. A. eastern equine encephalitis i. transmitted by Aedes, Coquillettidia, and Culex mosquitoes; birds are reservoirs B. Japanese encephalitis ii. transmitted by Culex tarsalis mosquitoes; has caused relatively few cases in the United States. C. St. Louis encephalitis iii. carried by three species of Culex mosquitoes; a serious outbreak occurred in 1975 D. western equine encephalitis iv. transmitted by Culex mosquitoes; birds are a reservoir; became a problem in the United States in 1999 TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 11 of 17 E. West Nile encephalitis v. worldwide, causes the most cases of vaccinepreventable encephalitis; reservoirs include birds and pigs Answers: A. i., B. v., C. iii., D. ii., E. iv. Difficulty: Difficult ASM Standard: 23 Fill in the Blank 50. The liquid within the central nervous system is called ________ fluid. Answer: cerebrospinal Difficulty: Easy ASM Standard: N/A 51. West Nile virus is transmitted by ________. Answer: mosquitoes Difficulty: Easy ASM Standard: 23 52. When symptoms are caused by the toxin produced by a pathogen, the condition is called a(n) ________. Answer: intoxication Difficulty: Easy ASM Standard: 23 53. Proteinaceous infectious particles are also known as ________. Answer: prions Difficulty: Easy ASM Standard: N/A 54. There is a vaccine available for ________ encephalitis, a type of viral encephalitis. Answer: Japanese Difficulty: Moderate ASM Standard: 14, 23 55. The reservoir for eastern equine encephalitis is ________. Answer: birds Difficulty: Moderate ASM Standard: 23 TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 12 of 17 56. Traditionally, rabies diagnosis relied on identifying ________ in central nervous system tissues. Answer: Negri bodies Difficulty: Moderate ASM Standard: 23 57. Jonas Salk developed a vaccine for ________. Answer: poliomyelitis Difficulty: Moderate ASM Standard: 14 58. ________ is a transmissible spongiform encephalopathy found in sheep. Answer: Scrapie Difficulty: Moderate ASM Standard: N/A 59. Individuals with transmissible spongiform encephalopathies develop ________ tangles and ________ plaques. Answer: neurofibrillary, amyloid Difficulty: Moderate ASM Standard: N/A 60. Patients exposed to rabies can be treated with rabies vaccine and rabies ________. Answer: immune globulin (antibodies) Difficulty: Difficult ASM Standard: 14, 23 61. Naegleria fowleri can be identified in CSF by using a modified trichome or ________ stain. Answer: Giemsa-Wright Difficulty: Difficult ASM Standard: 23 Short Answer 62. What composes the central nervous system? Sample Answer: The brain and spinal cord make up the central nervous system. Difficulty: Easy ASM Standard: N/A TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 13 of 17 63. What virus is associated with microcephaly in infants? Sample Answer: The Zika virus is associated with microcephaly in infants. Difficulty: Easy ASM Standard: 23 64. What symptoms appear soon after someone is exposed to botulinum neurotoxin through ingestion of contaminated food? Sample Answer: Exposure through the gastrointestinal tract initially causes gastrointestinal symptoms such as dysphagia (difficulty swallowing), nausea, vomiting, cramping, diarrhea, and/or constipation. It also causes blurred vision and drooping eyelids. The symptoms then progress and muscle weakness and flaccid paralysis follow. Difficulty: Easy ASM Standard: 23 65. What type of meningitis can be prevented by vaccination with the Hib vaccine? Sample Answer: Haemophilus influenzae type b meningitis can be prevented by vaccination with the Hib vaccine. Difficulty: Easy ASM Standard: 14, 23 66. What is the blood-brain barrier? Sample Answer: The blood-brain barrier refers to various mechanisms that collectively protect the brain from exposure to potential chemicals, toxins, and infectious agents found within the circulatory system. The materials that can travel from the circulatory system into the brain are restricted by the reduced permeability of brain capillaries, tight junctions in capillary endothelial cells, reduced fenestrate in cranial capillaries, and reduced numbers of pinocytic vesicles in cranial capillaries. Difficulty: Moderate ASM Standard: N/A 67. How do prions cause disease? Sample Answer: When abnormal (rogue) prion proteins (PrPSc) enter nervous tissue, they can cause normal prion proteins (PrPC ) to become folded incorrectly. Aggregations of abnormal proteins lead to the formation of fibrils that aggregate and kill cells. They contribute to the development of neurofibrillary tangles and amyloid plaques in the brain. Difficulty: Moderate ASM Standard: N/A 68. Why is listeriosis a risk even if food is refrigerated? Sample Answer: This pathogen can grow at relatively low temperatures, including those used for standard refrigeration. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 14 of 17 Difficulty: Moderate ASM Standard: 14, 23 69. How is botulism treated? Sample Answer: An antitoxin can be administered, but it does not reverse existing paralysis. An extended recovery period is needed to regain lost neurological functions. Difficulty: Moderate ASM Standard: 14, 23 70. What makes botulinum toxin useful in medicine? Sample Answer: Botulinum toxin causes paralysis, so it can be used to relax muscles. It is commonly used for cosmetic purposes (e.g., to relax facial muscles). It can also be used to reduce excessive sweating and to treat muscle contractions associated with cerebral palsy, multiple sclerosis, and Parkinson’s disease. Difficulty: Moderate ASM Standard: 23, 26 71. What symptoms are most commonly associated with West Nile virus infection? Sample Answer: Most patients (about 70% to 80%) do not have symptoms. Although dangerous meningitis or encephalitis can occur, about 99% of patients with symptoms have only mild flu-like symptoms. Difficulty: Moderate ASM Standard: 23 72. What treatments are used for leprosy? Sample Answer: Leprosy, or Hansen’s disease, is treated with dapsone, rifampin, and clofazimin. (Students may not have learned that clofazimin is used for patients with multibacillary disease, whereas dapsone and rifampin are generally recommended). Difficulty: Moderate ASM Standard: 14, 23 73. How is neurocysticercosis diagnosed? Sample Answer: Imaging tests can be used, including CT and MRI testing. Additionally, EIA and ELISA testing may be used. The presence of an elevated level of eosinophils in blood suggests a parasitic infection, although this is not a specific indicator for neurocysticercosis. Difficulty: Moderate ASM Standard: 23 74. Why is it difficult to eradicate rabies? TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 15 of 17 Sample Answer: Even if effective vaccination programs exist for domestic pets, the virus persists in wild animals. Difficulty: Difficult ASM Standard: 23 75. People are often told to get a tetanus shot if they experience a deep puncture wound such as a bite. Why is there a higher risk of tetanus from a deep puncture wound than from a shallow scrape or abrasion? Sample Answer: Clostridium tetani, the bacterium that causes tetanus by producing tetanus neurotoxin, is anaerobic and cannot grow in an oxygen-rich environment like that on the surface of the skin. Difficulty: Moderate ASM Standard: 23 76. What is the difference between tuberculoid and lepramatous leprosy? Sample Answer: Tuberculoid leprosy occurs if leprosy progresses beyond its mildest form. The symptoms include three or fewer lesions that may persist but that contain relatively few bacteria. In some cases, if the immune system is no longer able to contain the infection, the lepramatous form may develop. Lepramatous leprosy is associated with nerve damage and has the potential to cause disfiguring lesions. Difficulty: Difficult ASM Standard: 23 Brief Essay Essay Question Rubric RATING Failing Below Average Competent Advanced Criteria for evaluation Answer does not provide an argument. Answer contains inaccuracies. Writing is poor and contains numerous grammatical mistakes and misspellings. Answer fails to provide examples to support an argument. Writing is poor and grammatical errors are common. Answer is somewhat incoherent. Answer provides an argument with one or two examples that support it. Writing is acceptable for the college level but may contain one or two grammatical mistakes or misspellings. Answer clearly provides an argument with two or more excellent examples that support it; student makes the argument clearly and eloquently. Answer is well organized and free of grammatical errors and misspellings. POINT VALUE 0 1 2 3 Assume rating/grading scale for the question ranges from 0 to 3 points. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 16 of 17 77. Describe how pathogens can get from the circulatory system into the brain across the bloodbrain barrier. Answer: Student answers will vary but should include the following. There are four major ways that pathogens can cross the blood-brain barrier. First, they may have virulence factors that allow them entry between cells (i.e., intercellular mechanisms). Second, they may have virulence factors that let them use vacuole- or receptor-mediated mechanisms (i.e., transcellular mechanisms). Third, they may infect peripheral blood leukocytes and use these to cross the barrier (i.e., leukocyte-facilitated mechanisms). Fourth, they may travel through pathways outside of the circulatory system, such as along cranial nerves (i.e., nonhematogenous mechanisms). Difficulty: Moderate ASM Standard: 23 78. A college student with possible bacterial meningitis undergoes a lumbar puncture. Describe the test results that would lead to a positive diagnosis and indicate what treatment should be initiated if the results are positive. Answer: Student answers will vary but should include the following. Bacterial meningitis is diagnosed when an individual has more than 10 polymorphonuclear neutrophils/mm3 , less than 45 mg/dL of glucose, and greater than 45 mg/dL of protein in the CSF. Additional testing is needed to determine the type of bacterial meningitis. Hib meningitis can be treated with doxycycline, fluoroquinolones, second- and third-generation cephalosporins, and carbapenems. Cephalosporins or penicillins are used for meningococcal and pneumococcal meningitis. This would not be neonatal meningitis. Difficulty: Moderate ASM Standard: 14, 23 79. Explain why plasmapheresis can be helpful in treating patients with Guillain-Barré syndrome; include an explanation of what this syndrome is. Answer: Student answers will vary but should include the following. Guillain-Barré syndrome results from an autoimmune reaction, usually after bacterial or viral infection, and causes increasing neurological symptoms that can result in complete paralysis. The symptoms are caused by the individual producing antibodies that attack and damage the myelin sheaths that are essential for proper signal conduction. Plasmapheresis involves filtering the blood, meaning that the antibodies that are attacking the myelin can be removed. With appropriate supportive treatment, patients can recover fully. Difficulty: Difficult ASM Standard: N/A 80. When an individual is exposed to rabies, the treatment usually involves multiple components. What are these components and why are they all necessary? Answer: Student answers will vary but should include the following. Rabies is treated using multiple doses of rabies vaccine and often with rabies immune globulin. Rabies has an extended incubation period. The immune globulin has an immediate effect on the viral load, TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 26: Nervous System Infections Page 17 of 17 whereas vaccination causes the individual to produce rabies antibodies. By using immune globulin and then a series of vaccinations, the infection is slowed while the individual develops sufficient immune response to eliminate the virus. Difficulty: Difficult ASM Standard: 14, 23 81. Transmissible spongiform encephalopathies cannot currently be treated, so only supportive care is available. Although new diagnostic techniques are being developed, the primary method of diagnosing these diseases is through histological examination of brain tissue. Why has it been difficult to develop treatments for these diseases? If a patient with one of these diseases has surgery at a hospital, do you think that normal sterilization procedures would be sufficient to decontaminate surgical equipment? Explain all your answers. Answer: Student answers will vary but should include the following. It has been difficult to develop treatments because these diseases generally have long incubation periods, thus making it harder to trace their source and prevent others from being infected. Also, TSEs are very different from other pathogens such as bacteria, viruses, and fungi. TSEs do not have cellular structures to target. Additionally, the function of the normal protein that is affected by the abnormal prion protein is not known, even though possibilities have been proposed and are currently being researched. The chapter does not explicitly address the issue of surgical sterilization, although it mentions that clinicians must handle contaminated samples with care. Students may speculate about the effects of normal decontamination procedures, but the WHO and CDC recommend specific stringent sterilization procedures when a TSE may be present. Students may speculate that physical removal methods could remove some contaminated tissue. Sterilization techniques that kill spores and viruses are not necessarily sufficient to inactivate TSEs, although data are lacking on the effectiveness of different methods. Because this is not addressed directly in the chapter, student answers should be assessed on the basis of thoughtfulness and use of background knowledge regarding sterilization and TSEs separately, rather than on having a particular correct answer. Chapter 13 of the text contains more information about prions and students may refer back to the material in that chapter to elaborate further. “Diehard prions” in chapter 13 and the section on prions in chapter 6 may also be useful. Difficulty: Difficult ASM Standard: 14 This file is copyright 2017, Rice University. All rights reserved. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER