Chapter 10 Infectious Diseases and Sepsis Part 1

Chapter 10 Infectious Diseases and Sepsis 1) After receiving the hepatitis B vaccine, the blood of a paramedic reveals no circulating antibodies for the disease. Which of the following phases would the paramedic most likely be in regarding the immunization? A) Latent B) Window C) Incubation D) Seroconversion Answer: B Diff: 1 Page Ref: 399 Standard: Medicine (Infectious Diseases) Objective: 1, 5 2) Which of the following agencies is the primary agency responsible for establishing guidelines and standards to regulate health care worker safety as it relates to communicable disease transmission? A) NFPA B) CDC C) FEMA D) OSHA Answer: D Diff: 1 Page Ref: 394-395 Standard: Medicine (Infectious Diseases) Objective: 2 173 3) A paramedic within your service was treating an IV drug addict when the patient spit at her, hitting her in the eye. At the hospital, when asked for blood, the patient refused to consent for testing. In this case, which of the following is TRUE? A) The patient can be placed under detention and be required to give a blood sample. B) A judge will issue a court order requiring the patient to allow his blood to be tested. C) By law the patient is required to submit blood for testing. D) It is within the patient's right to refuse blood testing. Answer: D Diff: 2 Page Ref: 408 Standard: Medicine (Infectious Diseases) Objective: 6, 10 4) Which of the following measures is most important in protecting EMS providers from infectious disease? A) Thorough disinfection of the ambulance after every call B) Tuberculosis vaccination C) Hand washing after all patient contact D) Glove use for all patient contact Answer: C Diff: 1 Page Ref: 422 Standard: Medicine (Infectious Diseases) Objective: 6 5) For which of the following diseases is there no vaccine? A) Measles B) Croup C) Mumps D) Rubella Answer: B Diff: 1 Page Ref: 427 Standard: Medicine (Infectious Diseases) Objective: 6, 8 6) Which of the following statements about prions is TRUE? A) They are neither prokaryotes nor eukaryotes. B) Eastern equine encephalitis is the most common prion disease. C) Prions are easily destroyed by heat sterilization. D) Prions are single-celled animals capable of causing disease. Answer: A Diff: 2 Page Ref: 396 Standard: Medicine (Infectious Diseases) Objective: 1, 3 174 7) HIV attacks and destroys the: A) B lymphocytes. B) T lymphocytes. C) pluripotent stem cells. D) macrophages. Answer: B Diff: 1 Page Ref: 410 Standard: Medicine (Infectious Diseases) Objective: 8 8) Which of the following statements about herpes simplex type 2 (HSV-2) is FALSE? A) There is a low risk of disease transmission via casual contact. B) HSV-2 is responsible for 70 to 90 percent of all genital herpes cases. C) In addition to painful lesions to the infected area, fever and enlarged lymph nodes can be present during the initial presentation of the infection. D) Treatment with acyclovir can eradicate the virus. Answer: D Diff: 2 Page Ref: 434 Standard: Medicine (Infectious Diseases) Objective: 8 9) Which of the following statements about mumps is TRUE? A) Mumps are of no concern to the adult patient. B) There is no vaccine for the mumps virus. C) Mumps are characterized by enlargement of the salivary glands. D) Mumps are not highly communicable. Answer: C Diff: 2 Page Ref: 424 Standard: Medicine (Infectious Diseases) Objective: 8 10) Which of the following organisms causes mononucleosis? A) Epstein-Barr virus B) Pediculus humanus capitis C) Treponema D) Herpes zoster Answer: A Diff: 1 Page Ref: 426 Standard: Medicine (Infectious Diseases) Objective: 3, 8 175 11) All the following are common signs or symptoms of lice infestation EXCEPT: A) red macules or papules on the affected areas. B) white, oval-shaped nits on the hair shafts. C) itching. D) open lesions in the affected areas. Answer: D Diff: 1 Page Ref: 436-437 Standard: Medicine (Infectious Diseases) Objective: 7, 8 12) Your patient is a 40-year-old male. As a child he would have been least likely to have suffered from: A) RSV. B) pertussis. C) measles. D) mumps. Answer: B Diff: 1 Page Ref: 425, 426 Standard: Medicine (Infectious Diseases) Objective: 7 13) Which of the following agencies monitors national disease data and provides disease information to health care providers? A) DHHS B) CDC C) OSHA D) NIOSH Answer: B Diff: 1 Page Ref: 394 Standard: Medicine (Infectious Diseases) Objective: 2 14) Which of the following techniques destroys some, but not all, microorganisms? A) Cleaning B) Disinfection C) Decontamination D) Sterilization Answer: B Diff: 1 Page Ref: 407-408 Standard: Medicine (Infectious Diseases) Objective: 5, 9, 13 176 15) Which of the following is NOT a known transmission route for hepatitis B? A) Blood transfusion B) Dialysis C) Tattooing D) Insect bites Answer: D Diff: 1 Page Ref: 413 Standard: Medicine (Infectious Diseases) Objective: 4, 7, 9 16) Your patient was bitten on the hand by a wild raccoon he tried to capture. Which of the following is the first step in management for this patient? A) Irrigate the wound with sterile saline, dry the area around the wound, and apply a thin layer of antibiotic ointment. B) Clean the area with a povidone-iodine swab. C) Clean the area with an isopropyl alcohol pad. D) Wash the wound with soap and running water. Answer: D Diff: 2 Page Ref: 430-431 Standard: Medicine (Infectious Diseases) Objective: 9, 13 17) Health care workers can best avoid hepatitis B infection by: A) using standard precautions for all patients. B) using an alcohol-based hand sanitizer after each patient contact. C) completing the hepatitis B vaccine series. D) receiving gamma globulin in the event of an exposure. Answer: C Diff: 2 Page Ref: 413-414 Standard: Medicine (Infectious Diseases) Objective: 6 18) While working in the emergency department, you accidentally stick yourself with the stylette of an IV needle you just used to start an IV. What should you do immediately? A) Wash the area thoroughly with soap and running water. B) Stop the bleeding with a sterile gauze pad. C) Wipe the area with a povidone-iodine swab. D) Wipe the area with an alcohol prep. Answer: A Diff: 2 Page Ref: 402-404 Standard: Medicine (Infectious Diseases) Objective: 6, 10 177 19) Which of the following is best described as a change from the absence of antibodies to detectable levels of antibodies in the blood after exposure to an infectious disease? A) Clinical horizon B) Virulence C) Chemotaxis D) Seroconversion Answer: D Diff: 1 Page Ref: 399 Standard: Medicine (Infectious Diseases) Objective: 5 20) Which of the following cells play a functional role in the inflammatory response? A) Neutrophils B) T lymphocytes C) Stem cells D) B lymphocytes Answer: A Diff: 2 Page Ref: 399-400 Standard: Medicine (Infectious Diseases) Objective: 1, 5 21) Clostridium botulinum has its effect primarily by: A) altering cellular structure to create syncytia. B) releasing a toxin that results in muscular paralysis. C) creating gas through the fermentation of carbohydrates in muscle tissue. D) causing septicemia. Answer: B Diff: 2 Page Ref: 429 Standard: Medicine (Infectious Diseases) Objective: 3, 8 22) A memory or specific response is considered a(n) ________ response. A) cell-mediated B) inflammatory C) humoral D) immune Answer: C Diff: 2 Page Ref: 400 Standard: Medicine (Infectious Diseases) Objective: 1, 5 178 23) Which of the following types of agents acts specifically by inhibiting bacterial growth or reproduction? A) Bacteriostatic B) Antiseptic C) Pathological D) Aseptic Answer: A Diff: 1 Page Ref: 396 Standard: Medicine (Infectious Diseases) Objective: 1, 4 24) Demographics are: A) statistics related to the morbidity and mortality of all illnesses and injuries. B) geographical distributions of illness and injury. C) statistics related to the incidence of infectious disease. D) characteristics of human populations. Answer: D Diff: 1 Page Ref: 394 Standard: Medicine (Infectious Diseases) Objective: 2 25) Which of the following statements about rubella and the rubella virus is FALSE? A) EMS providers should receive an MMR vaccination. B) The virus is spread via contact with infected blood and body fluids. C) Immunization via the MMR vaccination is 98 to 99 percent effective. D) Infection in the first trimester of pregnancy increases the risk of birth defects. Answer: B Diff: 1 Page Ref: 425 Standard: Medicine (Infectious Diseases) Objective: 6, 8 26) The alternate pathway that reacts quickly to foreign bodies and uses antibodies and inflammation to combat pathogens is the ________ system. A) complement B) lymphatic C) humoral D) cell-mediated Answer: A Diff: 2 Page Ref: 400 Standard: Medicine (Infectious Diseases) Objective: 1, 5 179 27) Which of the following is a mobile, single-celled, parasitic organism? A) Fungus B) Virus C) Protozoan D) Bacterium Answer: C Diff: 1 Page Ref: 396 Standard: Medicine (Infectious Diseases) Objective: 1, 3 28) The destructive substances released from some bacteria when they die are known as: A) endotoxins. B) syncytia. C) prions. D) exotoxins. Answer: A Diff: 1 Page Ref: 395-396 Standard: Medicine (Infectious Diseases) Objective: 1, 3 29) A 44-year-old male staying in a homeless shelter is alert and complaining of shortness of breath. He has a two-week history of cough with hemoptysis, fever, chills, and night sweats. Physical examination reveals skin to be warm and moist and lung sounds decreased in the right upper lobe with rhonchi. HR = 100, BP = 142/100, RR = 20, SaO2 = 95%. You should assume this patient has a high likelihood of having: A) hantavirus pulmonary syndrome. B) tuberculosis. C) pneumonia. D) RSV. Answer: B Diff: 2 Page Ref: 414, 415 Standard: Medicine (Infectious Diseases) Objective: 7 30) Your patient is a 21-year-old male who is alert and oriented, complaining of a rash that started about 36 hours ago, first appearing on his trunk. The rash has now spread to his face and extremities. You notice multiple small, fluid-filled vesicles on the patient's body. The patient is concerned that he will miss work as a second-grade student teacher. He has no medical history, including childhood diseases. The patient is most likely suffering from: A) rubella. B) Epstein-Barr virus. C) herpes simplex. D) varicella. Answer: D Diff: 2 Page Ref: 420 Standard: Medicine (Infectious Diseases) Objective: 7 180 31) Mononucleosis presents with all the following signs and symptoms EXCEPT: A) enlarged and tender lymph nodes. B) fatigue. C) hepatomegaly. D) sore throat. Answer: C Diff: 1 Page Ref: 426 Standard: Medicine (Infectious Diseases) Objective: 8 32) Which of the following is classified as a helminth? A) Trichomonas B) Treponema C) Spirochete D) Fluke Answer: D Diff: 1 Page Ref: 393, 397 Standard: Medicine (Infectious Diseases) Objective: 1, 3 33) Which of the following statements about influenza and the influenza virus is FALSE? A) High-risk individuals include the elderly. B) An influenza vaccine confers immunity against only a few strains of the virus each year. C) Influenza is the leading cause of respiratory disease worldwide. D) The disease is characterized by nausea, vomiting, and diarrhea. Answer: D Diff: 2 Page Ref: 422-423 Standard: Medicine (Infectious Diseases) Objective: 8 34) You are suspicious that a patient is suffering from active tuberculosis. Which of the following would be most appropriate? A) Neither you nor the patient should wear a HEPA respirator. B) Both you and the patient should wear a HEPA respirator. C) You should wear an N95 mask. D) The patient should wear a HEPA respirator. Answer: C Diff: 2 Page Ref: 414-416 Standard: Medicine (Infectious Diseases) Objective: 6, 10 181 35) Your patient is a 23-year-old male prisoner who is alert and oriented, complaining of general malaise. He describes a month-long history of weakness, joint pain, nausea and occasional vomiting, and anorexia. He has no medical history and takes no medications. Physical examination reveals clear lung sounds bilaterally; warm, dry skin; several prison tattoos; a firm liver; and jaundice to his sclera. Which of the following is most likely? A) Fatty liver B) Cirrhosis of the liver C) HIV D) Hepatitis B Answer: D Diff: 3 Page Ref: 412, 413 Standard: Medicine (Infectious Diseases) Objective: 7 36) Which of the following statements about hepatitis A is TRUE? A) Hepatitis A is transmitted through direct contact with blood and body fluids. B) Many patients are asymptomatic with hepatitis A infection. C) Transmission via needle stick injury is common. D) The incubation period for hepatitis A is three to five days. Answer: B Diff: 1 Page Ref: 412 Standard: Medicine (Infectious Diseases) Objective: 8 37) Which of the following statements about measles and the measles virus is FALSE? A) Immunization is ineffective until age 15. B) Measles is highly communicable. C) Measles is transmitted by inhalation of infected droplets. D) Signs of measles infection include high fever and a maculopapular rash. Answer: A Diff: 2 Page Ref: 424 Standard: Medicine (Infectious Diseases) Objective: 8 38) Which hepatitis often presents with hepatitis D? A) A B) B C) C D) D Answer: B Diff: 1 Page Ref: 414 Standard: Medicine (Infectious Diseases) Objective: 8 182 39) Your patient is a 20-year-old female college student who lives in a dormitory. She complains of weakness, fever, chills, nausea, a rash on her chest, and neck pain. Physical examination reveals warm, moist skin; pain with flexion of her neck; and a petechial rash on her chest. HR = 92, BP = 108/68, RR = 14, SaO2 = 99%. Which of the following is most appropriate? A) Place an N-95 respirator on the patient, transport BLS, notify the hospital before arrival B) Place a face mask on your patient and yourself, transport BLS, notify the hospital before arrival C) Administer oxygen by nonrebreather, BLS, and transport D) Administer O2 via nonrebreather mask, cardiac monitor, IV of normal saline, and transport Answer: B Diff: 2 Page Ref: 421-422 Standard: Medicine (Infectious Diseases) Objective: 9, 10 40) From which of the following incidents would infection with Clostridium tetani be most likely? A) Eating improperly prepared, home-canned food B) Receiving a puncture wound to the foot C) Drinking contaminated well water D) Being bitten by an infected animal Answer: B Diff: 2 Page Ref: 431-432 Standard: Medicine (Infectious Diseases) Objective: 3, 8 41) Which of the following statements about Streptococcus pneumoniae is TRUE? A) Vaccines are ineffective against Streptococcus pneumoniae. B) It is the second most common cause of pneumonia in adults. C) It is the leading cause of meningitis in children. D) It is an infrequent cause of otitis media in children. Answer: B Diff: 1 Page Ref: 421 Standard: Medicine (Infectious Diseases) Objective: 3, 8 42) All the following pathogens typically cause meningitis in children EXCEPT: A) Haemophilus influenza type B B) Streptococcus pneumoniae C) Neisseria meningitidis D) Paramyxovirus Answer: D Diff: 1 Page Ref: 421 Standard: Medicine (Infectious Diseases) Objective: 3, 8 183