A patient is admitted who is complaining of headache, disorientation, and numbness in his left arm. He was bitten by a raccoon two days before. The FIRST step taken to help this patient would be

a. retrieving and testing the raccoon’s brain tissues for the rabies virus.

b. collecting a CSF sample from the patient.

c. performing a tissue biopsy on the patient to look for Negri bodies.

d. administering an anti-rabies vaccine as well as anti-rabies antibodies.

Viral meningitis is more common than other forms of meningitis because

a. these infectious agents are all intracellular, evading the immune system.

b. there are more types of viruses than bacteria because they evolve more quickly.

c. the small size of viruses makes them able to pass more easily through the blood–brain barrier.

d. viruses are spread person to person more easily than bacteria, fungi, or protozoans.

A patient’s lab data report has come back with a positive ELISA for pneumococcal C polysaccharide from CSF samples. The MOST appropriate next step for a health professional to recommend is to

a. culture from the CSF sample to test for antibiotic resistance.

b. administer tetracycline.

c. administer cephalosporin.

d. wait for RT-PCR confirmation before antibiotic treatment.

A patient under one year old is vomiting, drowsy, floppy (flaccid), and unresponsive. Both infant botulism and infant meningitis caused by other bacteria are suspected. Which piece of information would best help narrow down the possible diagnosis?

a. The child has spent almost no time outside the home.

b. The child is being breast-fed.

c. The child was born one month ago.

d. The child has a very high fever.

CSF glucose levels are often assessed to differentiate between bacterial and viral meningitis. This is because

a. bacteria cells use glucose and lower the overall concentration in the CSF.

b. viral meningitis causes inflammation that blocks glucose transport into the CSF.

c. viral infection of the meninges causes cell lysis, releasing glucose into the CSF.

d. None of the above.

During a lumbar puncture procedure, the nurse observed that the patient’s CSF pressure was high. However, when the analysis of the CSF sample comes back, the glucose levels are normal. The nurse would most likely suspect:

a. arboviral meningitis.

b. Neisseria meningitidis.

c. Listeria monocytogenes.

d. poliovirus.

A vaccine against Listeria monocytogenes is a challenge to develop because

a. very few people get Listeria meningitis.

b. the antibody-mediated immune response is not effective against L. monocytogenes.

c. better prevention approaches exist, such as food preparation precautions.

d. vaccinations are not used for foodborne illness.

Tetanospasmin and botulinum toxins affect muscles by

a. blocking the action potential traveling from the CNS to the PNS.

b. allowing the bacteria to enter neurons.

c. blocking the relaxation or contraction of the muscles.

d. damaging the axon itself.

A patient who has just immigrated to the United States after serving in the Iraqi army is displaying a bruiselike rash, headache, and sensitivity to light. The doctor will immediately recommend administration of

a. ceftriaxone.

b. penicillin.

c. gentamycin.

d. rifampicin.

The protists Trypanosoma brucei, Naegleria fowleri, and Toxoplasma gondii

a. invade host cells to cause cellular damage.

b. are only infective in the flagellated form.

c. have a nucleus and are eukaryotic.

d. have all of the above characteristics.

An HIV/AIDS patient is presenting with flulike symptoms, headache, fever, and disorientation. The MOST important piece of information a nurse must obtain for the patient is his or her

a. travel history, in and outside the United States.

b. diet for the last 3 days.

c. exposure to lakes or streams.

d. exposure to bats.

Which of the following symptoms would be most informative in terms of ruling out a prion disease as a differential diagnosis?

a. Nuchal rigidity

b. Hallucinations

c. Fatigue

d. Headache