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Which of the following would be an effective treatment for bacterial meningitis?

cephalosporins
MCV4
PCV
Hib vaccine
All of the above are correct.

cephalosporins

Which of the following statements concerning the blood-brain barrier is FALSE?

Most antibiotics cannot cross the blood-brain barrier.
Penicillin is useless against infections of the brain because it is completely incapable of crossing the barrier.
Inflammation can alter the blood-brain barrier, increasing the likelihood that a substance can cross.
Substances that are lipid-soluble can cross the blood-brain barrier readily.

Penicillin is useless against infections of the brain because it is completely incapable of crossing the barrier.

f a person in the United States is exposed to rabies, which animal is the most likely culprit?
domestic cats
domestic dogs
wild raccoon
wild bats

wild bats

Which of the following is an accurate description of Cryptococcus neoformans?

It is an ameba that inhabits freshwater and can cause rapidly fatal meningitis.
It is a bacterium that is found in the soil. It causes meningitis and is especially dangerous to pregnant women.
It is a mycobacterium; infection with this organism can cause disfiguring nodules all over the body.
It is a fungus found in dried pigeon droppings. When inhaled, it is especially dangerous to immunocompromised individuals and can cause fatal meningitis.

It is a fungus found in dried pigeon droppings. When inhaled, it is especially dangerous to immunocompromised individuals and can cause fatal meningitis.

Which of the following is an accurate statement concerning the Sabin and Salk vaccines?
The Salk vaccine is more effective in conferring immunity.
The Sabin vaccine is slightly more dangerous because it is made from live, attenuated virus, and the virus occasionally reverts back to its pathogenic form.
The Salk vaccine is cheaper to make than the Sabin vaccine.
The Salk vaccine is easier to administer because it is given orally.

The Sabin vaccine is slightly more dangerous because it is made from live, attenuated virus, and the virus occasionally reverts back to its pathogenic form.

Which of the following microbes has NOT been associated with bacterial meningitis?
Streptococcus pneumoniae
Haemophilus influenzae
Mycobacterium leprae
Neisseria meningitidis

Mycobacterium leprae

Which statement regarding arboviral encephalitis is FALSE?

Horses, as well as humans, are frequently affected by arboviruses.
The incidence of disease increases during summer months.
Most human cases of West Nile virus (WNV) are subclinical or very mild.
The most effective preventive measure for arboviral infections is vaccination.

The most effective preventive measure for arboviral infections is vaccination.

Postexposure treatment for rabies includes vaccination and injection of immunoglobulin; these are generally successful if treatment is obtained immediately following exposure. Why does post-exposure vaccination work?

The rabies exposure increases the speed of the adaptive immune response.
The infection progresses so slowly that there is time for post-exposure vaccination to generate immunity.
The immune response to this vaccine is very rapid.
The virus is highly exposed to the immune system once it enters the peripheral nerves.

The infection progresses so slowly that there is time for post-exposure vaccination to generate immunity.

Which of the following statements about meningitis is TRUE?

Meningitis is an infection of the cerebral tissue resulting when bacteria or viruses cross the blood brain barrier.
There are more than 50 bacterial species commonly associated with meningitis.
Viral meningitis, while less severe than bacterial meningitis, is more common in occurrence.
A vaccine exists to protect people against only meningitis caused by H. influenzae.

Viral meningitis, while less severe than bacterial meningitis, is more common in occurrence.

Why is bacterial meningitis considered more life threatening than viral meningitis?

The immune response generated against bacteria leads to a massive influx of immune cells in the meninges; this response is much less extreme in viral meningitis.
N. meningitidis produces an exotoxin that specifically kills immune cells resulting in a decreased ability to fight the infection.
It is rare that viral particles are able to cross the blood brain barrier.
Viral meningitis is easier to diagnose than bacterial meningitis; therefore treatment can begin earlier in infection.

The immune response generated against bacteria leads to a massive influx of immune cells in the meninges; this response is much less extreme in viral meningitis.

What is the likely cause for the drop in glucose levels?

Upon infection of the CSF, the body actively transports glucose from the CSF as a mechanism of "starving" the bacteria.
During infection glucose is preferentially taken up in anatomical locations required for generating the immune response (e.g. bone marrow); therefore glucose drops in other locations such as the CSF.
N. meningitidis uses the glucose as a source of energy to fuel its growth.
N. meningitidis produces a virulence factor which breaks down extracellular glucose so that immune cells are unable to use it as a source of energy.

N. meningitidis uses the glucose as a source of energy to fuel its growth.

What is a likely result of the elevated WBC level in Claire's CSF?

Due to the high number of WBCs that have moved to the CSF to fight the infection, the N. meningitidis will be quickly eliminated.
Due to the massive influx of WBCs, the cerebral tissue will be destroyed as the WBCs move from the CSF to the tissue.
Claire will be more susceptible to infections in other anatomical locations because the majority of her immune cells will be in her brain.
There will be an extreme inflammatory response which will eventually lead to shock and ultimately to Claire's death.

There will be an extreme inflammatory response which will eventually lead to shock and ultimately to Claire's death.

Why would conjugation to a protein carrier improve the efficacy (i.e. improve the immune response generated by the vaccine) of a polysaccharide vaccine?
Polysaccharides are not immunogenic and therefore do not elicit an immune response.
Proteins are much larger molecules than polysaccharides; therefore they stimulate a larger immune response.
The protein carrier allows the vaccine conjugate to be transported to more sites involved in generating the immune response therefore the overall response that is generated will be stronger.
In contrast to polysaccharide vaccines, protein-conjugated vaccines elicit a strong T-cell dependent response.

In contrast to polysaccharide vaccines, protein-conjugated vaccines elicit a strong T-cell dependent response.

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