4/4/2019 Chapter 21 Homework

Chapter 21 Homework
Due: 1:59pm on Wednesday, April 10, 2019
You will receive no credit for items you complete after the assignment is due. Grading Policy

Video Tutor: Hemorrhagic Fevers (Ebola)

Watch the Video Tutor on Hemorrhagic Fevers (Ebola) and then answer the questions below.

Part A
How is Ebola spread?

Hint 1.

The virus is enveloped and so does not survive long outside of a host.

ANSWER:

Mosquito bite

Direct contact with bodily fluids

It is airborne

Drinking contaminated water

Correct
Ebola may be contracted by coming into direct contact with contaminated bodily fluids like blood.

Part B
What causes the massive uncontrolled bleeding characteristic of Ebola infection?

Hint 1.
If the body is unable to create blood clots, hemorrhaging may ensue.

ANSWER:

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Depletion of clotting factors by infected macrophages.

Ebola infects platelets.

Blood pressure spikes cause aneurysms.

Ebola viruses release hemolytic toxins into the blood stream.

Correct
Infected macrophages trigger blood clots depleting the supply of clotting proteins in the bloodstream.

Part C
What is a special property of the “spacesuits” that prevents the virus from entering the suit of an Ebolavirus researcher?

Hint 1.
The suits use air to their advantage.

ANSWER:

They are made up of bulletproof material.

They are equipped with scuba tanks.

They have a positive pressure.

They are impregnated with antiviral drugs.

Correct
Positive pressure expels the viruses from the suit to prevent contact with the healthcare worker.

Part D
What term is used to describe the red and purple spots under the skin of an Ebola patient?

Hint 1.

The spots are actually tiny hemorrhages.

ANSWER:

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Erythema

Petechiae

Psoriasis

Cyanosis

Correct
Petechiae are tiny hemorrhages under the skin with a red to purple coloration.

Part E
Which antiviral has been shown effective in Ebola patients?
ANSWER:

There currently is no effective antiviral.

Interferon

Acyclovir

Tamifllu

Correct
Unfortunately antivirals are not effective against Ebola.

Part F
To which family does Ebolavirus belong?

Hint 1.
The family name is indicative of the structure of the virus.

ANSWER:

Herpesviridae

Caliciviridae

Filoviridae

Retroviridae

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Correct
Ebola is a long, filamentous virus.

Video Tutor: Malaria

Watch the Video Tutor on Malaria and then answer the questions below.

Part A
Which species of Plasmodium typically causes the most serious disease?

Hint 1.
It is very damaging to red blood cells.

ANSWER:

P. malariae

P. falciparum

P. vivax

P. ovale

Correct
P. falciparum causes the most severe symptoms such as black water fever and hemorrhages.

Part B
Which of the following phases of infection occurs in the mosquito?

Hint 1.
It is also the phase in which sexual reproduction occurs.

ANSWER:

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Sporogonic phase

Erythrocytic phase

Pyretic phase

Liver phase

Correct
The sporogonic phase includes the fusion of gametes in the mosquito gut.

Part C
The release of large quantities of merozoites into circulation at one time is due to a form of reproduction by Plasmodium
known as __________.

Hint 1.
This form of reproduction must result in large numbers before release into circulation.

ANSWER:

snapping division

budding

schizogony

binary fission

Correct
Schizogony involves the replication of many merozoites within a red blood cell, which are then released at one
time.

Part D
Which vector is required for the spread of malaria?

ANSWER:

The female Aedes mosquito.

The deer tick.

The male Anopheles mosquito.

The female Anopheles mosquito.

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Correct
The female Anopheles mosquito spreads the disease when she takes a blood meal to produce eggs.

Part E
Diagnosis of malaria relies on identification of trophozoites in a __________.

Hint 1.
Follow the symptoms to find the pathogen.

ANSWER:

liver biopsy

sputum sample

blood smear

urine sample

Correct
During active infection, the parasites should be visible in a blood smear.

Part F
The _____ form of the parasite has a characteristic “ring” shape.

Hint 1.
The ring shape occurs during the erythrocytic phase of infection.

ANSWER:

schizont

trophozoite

merozoite

sporozoite

Correct
The trophozoite forms a ring within red blood cells.

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Part G
Malaria used to be endemic in the U.S., but has not been prevalent for decades. How is this possible?
ANSWER:

Prophylaxis with quinine.

Widespread vaccination program.

The use of DEET in insect repellant.

The U.S. initiated a mosquito eradication program.

Correct
By eliminating the vector, the U.S. was able to control the spread of malaria.

Clinical Case: A Sick Camper

A Sick Camper

An otherwise healthy 24-year-old woman goes to her doctor complaining of a sudden onset of high fever, chills, uneasiness, and
a severe headache. She also shows the doctor a painful swelling she is experiencing in her groin area. The doctor asks her
about recent travel. She reports that she returned two days prior from a weeklong camping and hiking trip in Texas.

Part A
The Texas Department of Health has isolated Yersinia pestis from wood rats and prairie dogs in West Texas and the Texas
panhandle. In addition to the fever, chills, and severe headache, this patient has developed hemorrhages under the skin.
What disease is this camper likely to have?

Hint 1.
Consider the recent camping and hiking trip along with the signs and symptoms.

ANSWER:

septicemic plague

bubonic plague

tularemia

pneumonic plague

Correct
The recent camping and hiking experience, coupled with the signs and symptoms, is highly suggestive of bubonic
plague.

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Part B
What are swollen, painful lymph nodes called?

Hint 1.
Review the signs and symptoms associated with bubonic and pneumonic plague.

ANSWER:

Ghon complexes in the lungs

tabes

hives

buboes

Correct
In cases of the plague, these are most common in the groin and axillary areas.

Part C
Which of the following is a reservoir for the natural endemic cycle of Yersinia pestis?

Hint 1.
Review the terms reservoir, vector, amplifying host, and definitive host.

ANSWER:

dog

tick

flea

rat

Correct
A rat is a reservoir for Y. pestis. It harbors the organism but does not develop the disease.

Part D
Which of the following is an amplifying host of Yersinia pestis?

Hint 1.

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Review the terms reservoir, vector, amplifying host, and definitive host.

ANSWER:

rat

tick

rabbit

flea

Correct
Rabbits, prairie dogs, deer, camels, dogs, and cats are amplifying hosts for Y. pestis. The rabbit will harbor very
high numbers of bacteria and ultimately succumb to the disease.

Part E
What is the recommended medication for treatment of this disease?

Hint 1.

Review the mechanisms of action for common antibiotics.

ANSWER:

gentamicin

griseofulvin

erythromycin

acyclovir

Correct
Gentamicin is an antibiotic that has its effect on protein synthesis of prokaryotic cells.

Clinical Case: Nightmare on the Island

Nightmare on The Island

Peggy loves her time on The Island each year. Her parents had taken her every year to the resort destination as a girl, and now
she was doing the same with her children. Their seaside home near Cape Cod, Massachusetts, was modest in comparison to
some of the neighbors’, but it had been in Peggy’s family for over a hundred years, and she had fond remembrances from every
stage of her life. One of Peggy’s fondest memories is playing tag with her friends on the lawns of The Island’s homes. Now, she
smiles as she watches her eight-year-old son, Jacob, help the older son of one of her childhood girlfriends mow the grassy
expanse. “Building memories--that’s what it’s about,” she thought. Little does she know that some memories can build
nightmares.

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Three days later, Jacob wakes up complaining of a scratchy throat, headache, and “soreness all over.” Peggy is concerned
about his dry cough and 103 degrees Fahrenheit temperature. “A summer cold?” She keeps Jacob in bed, which isn’t difficult
because his breathing becomes more labored and painful. Two days later, he begins coughing up blood and Peggy recognizes
that this isn’t an ordinary summertime cold.

She rushes Jacob to the local clinic, where the doctor orders immediate intravenous streptomycin and transport to a hospital on
the mainland. The physician tells Peggy that Jacob is likely infected with the most virulent bacterium known. He questions her
about Jacob’s activities on the island: Has the boy touched any animals? Done any outdoor activities? Been bitten by a tick?
“No, no, no.” Then she recalls that Jacob helped mow the grass earlier in the week.

Within days, Jacob feels better and can answer questions. He tells the doctor that the lawnmower had run over the dried body of
a small dead rabbit. The physician suspects the mower had spewed bacteria into the air; Jacob had inhaled a near-fatal dose.

The grassy lawn will no longer recall the fond memories of Peggy’s childhood; instead, she will remember men in biohazard suits
taking samples, documenting the nightmarish time she almost lost her son.

Part A
What disease is afflicting Jacob?

Hint 1.
Consider the signs, symptoms, and incubation period to provide you with an index of suspicion that points to a
specific disease.

ANSWER:

salmonellosis

plague

tularemia

bartonellosis

Correct
The signs, symptoms, and incubation period are consistent with a diagnosis of tularemia.

Part B
Why is exposure to the rabbit significant?

Hint 1.
Differentiate between vector, intermediate host, amplifying host, incidental host, and reservoir.

ANSWER:

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Rabbits are reservoirs for Francisella tularensis.

Rabbits are vectors for Francisella tularensis.

Rabbits are reservoirs for shigellosis.

Rabbits are amplifying hosts for Francisella tularensis.

Correct
Rabbits are reservoirs for Francisella tularensis.

Part C
Why was Jacob given streptomycin, not penicillin?

Hint 1.
Review the mechanisms of action for common antibiotics.

ANSWER:

Antibiotics are unable to penetrate the capsule of Francisella tularensis.

Francisella tularensis produces β-lactamase.

Francisella tularensis has flagella and can “outswim” the antibiotics.

Francisella tularensis produces a neurotoxin to neutralize penicillin.

Correct
Penicillin is not an effective treatment for Francisella tularensis. This organism produces β-lactamase.

Part D
Which of the following is NOT a virulence factor associated with Francisella tularensis?

Hint 1.

Review the different virulence factors associated with bacteria.

ANSWER:

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capsule

pili

flagella

endotoxin

Correct
Francisella tularensis is an intracellular pathogen that does not produce flagella.

Part E
A subset of select agents and toxins have been designated as Tier 1 because these biological agents and toxins present the
greatest risk of deliberate misuse with significant potential for mass casualties or devastating effect to the economy, critical
infrastructure, or public confidence. They also pose a severe threat to public health and safety. Why is Francisella tularensis
considered a select agent?

Hint 1.
Review the modes of transmission and virulence factors for Francisella tularensis.

ANSWER:

Francisella tularensis is an intracellular parasite.

Francisella tularensis can produce endospores.

Francisella tularensis is Gram-negative and produces endotoxin.

Francisella tularensis can penetrate unbroken skin. Disease can result from as few as 10 organisms, and there
are many different modes of transmission.

Correct
Francisella tularensis can penetrate unbroken skin. The disease can result from as few as 10 organisms, and
there are many different modes of transmission.

Score Summary:
Your score on this assignment is 100%.
You received 2 out of a possible total of 2 points.

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