CME examination Identification No. 880-105

See "Instructions for Category 1 CME Credit" on page 23A of the front advertising section.

Questions 1-33, Burnett JW: J AM ACAD DERMATOL 2:359-373, 1980.

Directions for questions 1-12: Give sillgle best response.

I. All of the following are members of the genus Rickettsia, EXCEPT: a. R. australis b. R. callada c. R. mooseri d. R. quimallQ e. R. tsutsugamushi

2. Cell culture of which of the following organisms should be carried out at 32 C? a. R. callada b. R. mooseri c. R. prowazekii d. R. rickettsii e. R. tsutsugamushi

3. Medial necrosis of blood vessel walls is particu­larly characteristic of a. endemic (murine) typhus b. scrub typhus c. Rocky Mountain spotted fever d. North Asian tick-borne fever e. rickettsialpox

4. Infection with which of the following rickettsiae leads to rapid death of the vector? a. R. akari b. R. australis c. R. callada d. R. cOllorii e. R. proll'azekii

5. Multiple serotypes with only transient cross­immunization among them following infection is characteristic of a. epidemic typhus b. endemic typhus c. scrub typhus d. Rocky Mountain spotted fever e. boutonneuse fever

6. A rapid rise in specific IgG antibody titer without a preceding increase in IgM antibody is characteris­tic of a. Brill-Zinsser disease b. epidemic typhus

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c. endemic typhus d. Rocky Mountain spotted fever e. rickettsialpox

7. In managing a patient with Rocky Mountain spot­ted fever, the chief drawback in using the Weil­Felix test is a. frequent false-negative reactions oc'cur b. frequent false-positive reactions occur c. it is insufficiently specific d. it does not become positive until after therapy

should have been started e. it is usually negative in this disease

8. Immunity to endemic typhus follows infection with a. R. akari b. R. allstralis c. R. cOllorii d. R. prowazekii e. R. siberica

9. An individual who moved from Aspen, CO, to rural Georgia would particularly increase his or her risk of contracting a. boutonneuse fever b. Rocky Mountain spotted fever c. rickettsialpox d. scrub typhus e. trench fever

10. A mite-infested house mouse in Toronto would be most likely to be infected with a. R. callada b. R. akari c. R. //Iooseri d. R. proll'azekii e. R. quilltalla

II. A patient presenting at Harlem Hospital in New York City would be LEAST likely to have a. epidemic typhus b. endemic typhus c. Brill-Zinsser disease d. rickettsialpox e. trench fever

12. A marked increase in mortality is observed in pa­tients with Rocky Mountain spotted fever if initia-

Volume 2 Number 5 May, 1980

tion of therapy is delayed, following onset of the disease, more than a. 3 days b. 5 days c. 7 days d. 9 days e. 11 days

Directions for questions 13-17: Select the one let­tered item that is most closely related to each numbered item.

a. R. akari h.R. proll'azekii c. R. qlli1ltalla d. R. ·rickettsii e. R. tsutsllgamushi

13. Rocky Mountain spotted fever 14. Rickettsialpox 15. Brill-Zinsser disease 16. Scrub typhus 17. Trench fever

Directiolls for questiolls 18-22: Select the one let­tered item that is mosl closely related to each Ilumbered item.

a. Chiggers b. Fleas c. Lice d. Mites e. Ticks

18. Epidemic typhus 19. Endemic typhus 20. Trench fever 21. Boutonneuse fever 22. Rickettsialpox

Directions for questions 23-27: Select the one let­tered item that is 11I0s1 closely related 10 each numbered item.

a. Alloderman),ssus b. Leptotroll/bidil/Ill c. Ixodes d. Siphonaptera e. Rhipicephalus

23. A flea

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24. An adult mouse mite 25. An immature trombiculid mite, or chigger 26. A tick whose larvae survive in crevases in build-

ings during winter 27. A hard or "wood" tick

Directions for questions 28 and 29: For each numbered item choose the appropriate lettered item.

a. Protells OX-2 agglutinins b. Proteus OX-K agglutinins c. Both d. Neither

28. Weil-Felix reaction 29. Scrub typhus

Directions for questions 30-33: Indicate correct answers. All, some, or none of the choices may be true. 30. Transovarian infection in the vector occurs in

a. epidemic typhus b. endemic typhus c. scrub typhus d. Rocky Mountain spotted fever e. rickettsialpox

31. Genera of ticks include a. Dermacellfor b. Leptotro111bidiu111 c. Siphonaptera d. Rhipicephalus e. Ixodes

32. A positive Protells OX-19 titer is characteristically found at some stage of a. epidemic typhus b. Brill-Zinsser disease c. scrub typhus d. rickettsialpox e. Rocky Mountain spotted fever

33. An effective, commercially prepared vaccine using ki/Jed organisms is currently available for a. boutonneuse fever b. North Asian tick-borne rickettsiosis. c. Queensland tick typhUS d. Rocky Mountain spotted fever e. endemic typhus