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The medical specialties most concerned with polio are cardiology and pulmonology.
Answer: False
Explanation: The medical specialties primarily concerned with poliomyelitis are neurology and infectious disease, as it affects the nervous system and is caused by a pathogen.
Poliomyelitis was first recognized as a distinct medical condition in the late 19th century by Karl Landsteiner.
Answer: False
Explanation: Poliomyelitis was first recognized as a distinct medical condition in 1789 by Michael Underwood, not in the late 19th century by Karl Landsteiner, who identified the poliovirus in 1909.
The term 'poliomyelitis' is derived from Ancient Greek words referring to the inflammation of the brain's white matter.
Answer: False
Explanation: The term 'poliomyelitis' is derived from Ancient Greek words meaning 'inflammation of the spinal cord's grey matter,' not the brain's white matter.
What is the common name for poliomyelitis?
Answer: Polio
Explanation: Poliomyelitis is commonly shortened to polio, and is also known as infantile paralysis or Heine–Medin disease.
Which two medical specialties are primarily concerned with poliomyelitis?
Answer: Neurology and Infectious Disease
Explanation: The medical specialties primarily concerned with poliomyelitis are neurology, due to its impact on the nervous system, and infectious disease, as it is caused by a pathogen.
Who first recognized poliomyelitis as a distinct medical condition in 1789?
Answer: Michael Underwood
Explanation: The English physician Michael Underwood is credited with first recognizing poliomyelitis as a distinct medical condition in 1789.
In what year was the poliovirus first identified?
Answer: 1909
Explanation: The poliovirus was first identified in 1909 by the Austrian immunologist Karl Landsteiner.
What is the etymological meaning of 'poliomyelitis'?
Answer: "Inflammation of the spinal cord's grey matter"
Explanation: The term 'poliomyelitis' is derived from Ancient Greek words meaning 'inflammation of the spinal cord's grey matter'.
What historical evidence suggests the ancient presence of polio?
Answer: Egyptian paintings and carvings depicting people with withered limbs.
Explanation: Historical evidence for the ancient presence of polio includes Egyptian paintings and carvings depicting individuals with withered limbs, and archaeological findings like the remains of a teenage girl from a 4000-year-old burial site showing characteristic symptoms.
Poliomyelitis is an infectious disease caused by a bacterium that primarily affects the digestive system.
Answer: False
Explanation: Poliomyelitis is caused by the poliovirus, not a bacterium, and while it enters through the mouth and initially infects the pharynx and intestinal mucosa, its primary severe impact is on the nervous system, not solely the digestive system.
Approximately three-quarters of poliovirus cases are asymptomatic, showing no initial symptoms.
Answer: True
Explanation: In individuals with a normal immune system, approximately 72% to 75% of poliovirus infections are asymptomatic, meaning they do not produce any noticeable symptoms.
The source mentions four distinct types of wild poliovirus (WPV1, WPV2, WPV3, and WPV4).
Answer: False
Explanation: The source specifies three types of wild poliovirus: type 1, type 2, and type 3. It does not mention a WPV4.
Poliovirus is primarily transmitted through airborne droplets, similar to the common cold.
Answer: False
Explanation: Poliovirus is primarily transmitted through the fecal–oral route, involving the ingestion of contaminated food or water, and also via the oral–oral route, not airborne droplets.
Adults are generally less likely to develop severe polio symptoms, including paralysis, compared to children.
Answer: False
Explanation: Adults are more likely to develop symptoms, including severe symptoms and paralysis, from poliovirus infection compared to children. For example, paralysis occurs in about one in 75 adult cases, versus one in 1000 children.
Acute flaccid paralysis occurs in about one to five out of every 1,000 poliovirus cases that progress to paralytic disease.
Answer: True
Explanation: Acute flaccid paralysis, characterized by muscle weakness and eventual complete paralysis, occurs in approximately one to five out of every 1,000 poliovirus cases that progress to paralytic disease.
Encephalitis, a rare polio complication, is typically restricted to adults and involves inflammation of the spinal cord.
Answer: False
Explanation: Encephalitis, a rare polio complication, is usually restricted to infants and involves inflammation of the brain tissue itself, not the spinal cord.
The poliovirus naturally affects humans, chimpanzees, and certain species of monkeys.
Answer: False
Explanation: Poliomyelitis naturally affects only humans; it does not affect any other species.
Wild poliovirus type 1 (WPV1) is the most commonly encountered form and is most closely associated with paralysis.
Answer: True
Explanation: Wild poliovirus type 1 (WPV1) is indeed the most commonly encountered form of the virus and is most strongly linked to the development of paralysis.
The incubation period for the onset of paralysis after poliovirus exposure is typically between 3 and 6 days.
Answer: False
Explanation: The incubation period for the onset of paralysis after poliovirus exposure typically occurs within 7 to 21 days, whereas 3 to 6 days is the range for nonparalytic polio symptoms.
Pregnancy, extreme age, immune deficiency, and malnutrition are all factors that can increase the risk of polio infection.
Answer: True
Explanation: Pregnancy, being very old or very young, immune deficiency, and malnutrition are all identified factors that increase an individual's risk of poliovirus infection.
Poliovirus enters the body through the mouth and primarily infects cells in the lungs before spreading.
Answer: False
Explanation: Poliovirus enters the body through the mouth and initially infects cells in the pharynx and intestinal mucosa, not primarily the lungs.
Viremia refers to the presence of the poliovirus in the bloodstream, which can lead to minor influenza-like symptoms.
Answer: True
Explanation: Viremia is defined as the presence of poliovirus in the bloodstream, and sustained viral replication during this phase can indeed lead to minor influenza-like symptoms.
Paralytic poliomyelitis is characterized by the poliovirus destroying sensory neurons, leading to a loss of sensation.
Answer: False
Explanation: Paralytic poliomyelitis is characterized by the poliovirus preferentially replicating in and destroying *motor neurons*, which leads to muscle weakness and paralysis, not a loss of sensation from sensory neuron destruction.
Spinal polio is the most common form of paralytic poliomyelitis, affecting motor neurons in the spinal column's grey matter.
Answer: True
Explanation: Spinal polio is indeed the most common form of paralytic poliomyelitis, resulting from the poliovirus invading and destroying motor neurons in the anterior horn cells of the spinal column's grey matter.
Bulbospinal polio is particularly dangerous because it affects the upper cervical spinal cord, potentially paralyzing the diaphragm and swallowing muscles.
Answer: True
Explanation: Bulbospinal polio is particularly dangerous as it affects the upper cervical spinal cord, leading to paralysis of the diaphragm and muscles essential for swallowing, often necessitating mechanical ventilation.
The case fatality rate for paralytic polio is higher in children than in adults.
Answer: False
Explanation: The case fatality rate for paralytic polio is higher in adults (15-30%) than in children (2-5%).
What percentage of poliovirus cases are typically asymptomatic?
Answer: Approximately 75%
Explanation: Approximately 72% to 75% of poliovirus cases are asymptomatic, meaning individuals show no noticeable symptoms.
How is poliovirus primarily transmitted from person to person?
Answer: Through the fecal–oral route
Explanation: Poliovirus is primarily transmitted from person to person through the fecal–oral route, involving the ingestion of food or water contaminated by human feces, and also via the oral–oral route.
How does the likelihood of developing severe polio symptoms differ between adults and children?
Answer: Adults are more likely to develop severe symptoms than children.
Explanation: Adults are more susceptible to developing severe symptoms, including paralysis, from poliovirus infection compared to children.
What condition, characterized by headache, neck stiffness, and body pain, develops in most patients with CNS involvement from poliovirus?
Answer: Nonparalytic aseptic meningitis
Explanation: Most patients with central nervous system (CNS) involvement from poliovirus develop nonparalytic aseptic meningitis, which is characterized by symptoms such as headache, neck stiffness, and generalized body pain.
Which species is naturally affected by poliomyelitis?
Answer: Only humans
Explanation: Poliomyelitis naturally affects only humans; it does not affect any other species.
Which wild poliovirus serotype is most commonly associated with paralysis?
Answer: Wild poliovirus type 1 (WPV1)
Explanation: Wild poliovirus type 1 (WPV1) is the most commonly encountered form and is most strongly associated with the development of paralysis.
What is the typical incubation period for the onset of paralysis after poliovirus exposure?
Answer: 7 to 21 days
Explanation: The incubation period for the onset of paralysis after poliovirus exposure typically ranges from 7 to 21 days.
Which of the following is NOT listed as a factor that increases the risk of polio infection?
Answer: Being middle-aged
Explanation: Factors that increase the risk of polio infection include pregnancy, extreme age (very old or very young), immune deficiency, and malnutrition. Being middle-aged is not listed as a risk factor.
How does poliovirus initially gain entry into host cells?
Answer: By binding to the CD155 receptor on the cell membrane.
Explanation: Poliovirus gains entry into host cells by binding to the CD155 receptor on the cell membrane, after which it hijacks the host cell's machinery for replication.
What is the primary characteristic of paralytic poliomyelitis at the cellular level?
Answer: Preferential replication in and destruction of motor neurons.
Explanation: Paralytic poliomyelitis is fundamentally characterized by the poliovirus preferentially replicating in and destroying motor neurons within the spinal cord, brain stem, or motor cortex.
Which form of paralytic poliomyelitis affects the brain stem's bulbar region, causing difficulty breathing, speaking, and swallowing?
Answer: Bulbar polio
Explanation: Bulbar polio affects the brain stem's bulbar region, destroying nerves that control muscles for breathing, speaking, and swallowing, leading to significant difficulties in these functions.
What is the case fatality rate (CFR) for paralytic polio in adults?
Answer: 15 to 30 percent
Explanation: The case fatality rate (CFR) for paralytic polio in adults is significantly higher than in children, ranging from 15 to 30 percent.
Post-polio syndrome is a rare complication that occurs immediately after recovery from the initial infection.
Answer: False
Explanation: Post-polio syndrome is a condition that affects 25% to 50% of individuals who recovered from paralytic polio in childhood, developing new muscle weakness and fatigue decades after the initial infection, not immediately.
Polio can be diagnosed by detecting antibodies against the virus in a person's blood or by finding the virus in their feces.
Answer: True
Explanation: Poliomyelitis is diagnosed by identifying the poliovirus in a patient's feces or by detecting specific antibodies against the virus in their blood.
Once a person is infected with polio, there is a specific antiviral cure available to treat the disease.
Answer: False
Explanation: There is no specific antiviral treatment or cure for an established poliovirus infection; management focuses on supportive care to alleviate symptoms and prevent complications.
The iron lung is still a primary medical device used today for polio patients requiring respiratory assistance.
Answer: False
Explanation: The iron lung, a historical medical device for respiratory assistance in polio patients, is now largely obsolete due to the development of more modern breathing therapies and the widespread eradication of polio.
Patients who develop only aseptic meningitis from polio can expect a complete recovery within a few weeks.
Answer: True
Explanation: Patients who develop only aseptic meningitis from poliovirus infection can expect symptoms to persist for two to ten days, followed by a complete recovery.
Nerve terminal sprouting is a neurophysiological process where new motor neurons are generated to replace those destroyed by the poliovirus.
Answer: False
Explanation: Nerve terminal sprouting is a process where *remaining* motor neurons develop new branches to reinnervate orphaned muscle fibers, not where *new* motor neurons are generated to replace destroyed ones.
Equinus foot is a complication of polio where the foot points upward due to overactive muscles that pull the toes upward.
Answer: False
Explanation: Equinus foot is a complication of paralytic polio where the foot tends to drop toward the ground because the upward-pulling muscles are non-functional, not due to overactive muscles pulling the toes upward.
Post-polio syndrome (PPS) typically affects individuals who had nonparalytic polio in childhood, causing new muscle weakness decades later.
Answer: False
Explanation: Post-polio syndrome (PPS) typically affects individuals who recovered from *paralytic* polio in childhood, causing new muscle weakness and extreme fatigue decades later.
Which of the following is a potential severe complication of polio that can occur years after recovery?
Answer: Post-polio syndrome
Explanation: Post-polio syndrome is a severe complication characterized by new muscle weakness and extreme fatigue that can develop decades after recovery from the initial paralytic polio infection.
What historical medical device was used to assist polio patients with breathing but is now largely obsolete?
Answer: Iron lung
Explanation: The iron lung was a historical noninvasive, negative-pressure ventilator used to artificially maintain respiration in polio patients, but it is now largely obsolete.
What is the typical recovery outcome for patients who develop only aseptic meningitis from polio?
Answer: They can expect a complete recovery within two to ten days.
Explanation: Patients who develop only aseptic meningitis from poliovirus infection can expect a complete recovery, with symptoms typically resolving within two to ten days.
What neurophysiological process helps restore muscle strength after acute paralytic poliomyelitis?
Answer: Nerve terminal sprouting from remaining motor neurons.
Explanation: Nerve terminal sprouting, where remaining motor neurons develop new branches to reinnervate orphaned muscle fibers, is a neurophysiological process that contributes to the restoration of muscle strength after acute paralytic poliomyelitis.
What is 'equinus foot' as a complication of paralytic polio?
Answer: A condition where the foot tends to drop toward the ground because upward-pulling muscles are non-functional.
Explanation: Equinus foot is a residual complication of paralytic polio where the foot tends to drop toward the ground because the muscles responsible for dorsiflexion (pulling the foot upward) are non-functional, while plantarflexion muscles remain active.
What is post-polio syndrome (PPS)?
Answer: A condition where 25% to 50% of individuals who recovered from paralytic polio in childhood develop new muscle weakness and extreme fatigue decades later.
Explanation: Post-polio syndrome (PPS) is a condition affecting 25% to 50% of individuals who recovered from paralytic polio in childhood, characterized by the development of new muscle weakness and profound fatigue decades after the initial infection.
The injected polio vaccine (IPV) contains an attenuated, or weakened, live virus, while the oral polio vaccine (OPV) uses inactivated poliovirus.
Answer: False
Explanation: The injected polio vaccine (IPV) uses inactivated poliovirus, whereas the oral polio vaccine (OPV) contains an attenuated, or weakened, live virus. The statement reverses these characteristics.
Circulating vaccine-derived poliovirus (cVDPV) arises when the inactivated virus in the IPV mutates after prolonged circulation.
Answer: False
Explanation: Circulating vaccine-derived poliovirus (cVDPV) arises when the *weakened live virus* in the *oral polio vaccine (OPV)* mutates after prolonged circulation in under-immunized communities, not from the inactivated virus in IPV.
The Salk vaccine (IPV) was developed by Albert Sabin and announced in 1952.
Answer: False
Explanation: The Salk vaccine (IPV) was developed by Jonas Salk and announced in 1955, while Albert Sabin developed the oral polio vaccine (OPV).
The oral polio vaccine (OPV) is advantageous in global eradication efforts because it is expensive to produce but easy to administer.
Answer: False
Explanation: The oral polio vaccine (OPV) is advantageous in global eradication efforts because it is *inexpensive* and easy to administer, not expensive.
The Novel oral polio vaccine type 2 (nOPV2) is less likely to revert to a virulent form than the traditional OPV due to its greater genetic stability.
Answer: True
Explanation: The Novel oral polio vaccine type 2 (nOPV2) is indeed significant for its greater genetic stability, which makes it less likely to revert to a virulent form and cause vaccine-derived polio compared to the traditional OPV.
What is the main method of preventing polio?
Answer: Vaccination with the polio vaccine
Explanation: The main method of preventing poliomyelitis is through vaccination with the polio vaccine, which requires multiple doses for lifelong protection.
What is the primary difference between the injected polio vaccine (IPV) and the oral polio vaccine (OPV)?
Answer: IPV uses inactivated poliovirus, while OPV contains an attenuated, live virus.
Explanation: The injected polio vaccine (IPV) utilizes inactivated poliovirus, whereas the oral polio vaccine (OPV) contains an attenuated, live virus. This is the fundamental difference in their composition and mechanism.
What is circulating vaccine-derived poliovirus (cVDPV)?
Answer: A weakened live virus from the oral polio vaccine that has mutated and reverted to a virulent form.
Explanation: Circulating vaccine-derived poliovirus (cVDPV) arises when the weakened live virus in the oral polio vaccine (OPV) is transmitted in under-immunized communities and, through prolonged circulation, mutates and reverts to a virulent form capable of causing illness and paralysis.
Who developed the inactivated polio vaccine (IPV)?
Answer: Jonas Salk
Explanation: Jonas Salk developed the inactivated polio vaccine (IPV) at the University of Pittsburgh.
What is a key advantage of the oral polio vaccine (OPV) in global eradication efforts?
Answer: It produces excellent immunity in the intestine and can provide community immunity.
Explanation: A key advantage of the oral polio vaccine (OPV) in global eradication efforts is its ability to produce excellent immunity in the intestine, which helps prevent wild virus infection and can provide community immunity by spreading to unvaccinated contacts.
What is the significance of the Novel oral polio vaccine type 2 (nOPV2)?
Answer: It has greater genetic stability, making it less likely to revert to a virulent form.
Explanation: The Novel oral polio vaccine type 2 (nOPV2) is significant for its enhanced genetic stability, which reduces its likelihood of reverting to a virulent form and causing vaccine-derived polio compared to traditional OPV.
As of October 2023, only Pakistan and Afghanistan remained endemic for wild poliovirus.
Answer: True
Explanation: As of October 2023, the only countries where wild poliovirus (WPV) remained endemic were Pakistan and Afghanistan.
The Global Polio Eradication Initiative (GPEI) was established in 1988 and is led by the World Health Organization, UNICEF, and The Rotary Foundation.
Answer: True
Explanation: The Global Polio Eradication Initiative (GPEI) was indeed launched in 1988 and is led by the World Health Organization (WHO), UNICEF, and The Rotary Foundation.
Smallpox and measles are the only diseases completely eradicated by humankind according to the source.
Answer: False
Explanation: According to the source, the only diseases completely eradicated by humankind are smallpox and rinderpest, not measles.
The Americas were declared polio-free in 2002, following Europe's eradication in 1994.
Answer: False
Explanation: The Americas were declared polio-free in 1994, and Europe was declared polio-free in 2002. The statement reverses these dates.
A fatwa issued in northern Nigeria in 2003 falsely claimed the polio vaccine caused sterility, leading to a setback in eradication efforts.
Answer: True
Explanation: In 2003, a fatwa was indeed issued in northern Nigeria, falsely claiming the polio vaccine caused sterility, which significantly set back eradication efforts in Africa.
Africa was declared free of wild polio in August 2020, and all forms of poliovirus have since been eliminated from the continent.
Answer: False
Explanation: While Africa was declared free of wild polio in August 2020, cases of circulating vaccine-derived poliovirus type 2 continue to appear in several African countries, meaning not all forms have been eliminated.
As of October 2023, which two countries remained endemic for wild poliovirus (WPV)?
Answer: Pakistan and Afghanistan
Explanation: As of October 2023, Pakistan and Afghanistan were the only two countries that remained endemic for wild poliovirus (WPV).
When did the Global Polio Eradication Initiative (GPEI) begin?
Answer: 1988
Explanation: The Global Polio Eradication Initiative (GPEI) was launched in 1988.
According to the source, which two diseases, besides polio, have been completely eradicated by humankind?
Answer: Smallpox and Rinderpest
Explanation: According to the source, the only diseases completely eradicated by humankind to date are smallpox (1980) and rinderpest (2011).
What incident in 2003 significantly set back polio eradication efforts in northern Nigeria?
Answer: A fatwa falsely declaring the polio vaccine caused sterility.
Explanation: In 2003, a fatwa was issued in northern Nigeria, falsely claiming the polio vaccine caused sterility, which led to a significant setback in polio eradication efforts in the region.
When was Africa declared free of wild polio?
Answer: August 2020
Explanation: Africa was declared free of wild polio in August 2020.
Why should polio vaccination programs continue for at least ten years even after global elimination?
Answer: To manage risks associated with live poliovirus samples in laboratories and manufacturing facilities.
Explanation: Polio vaccination programs should continue for at least ten years post-global elimination to mitigate the risks associated with live poliovirus samples retained in laboratories and vaccine manufacturing facilities, which pose a potential threat of virus escape.
Improvements in 19th-century sanitation paradoxically contributed to polio epidemics by reducing early childhood exposure and thus population-wide herd immunity.
Answer: True
Explanation: Improvements in 19th-century sanitation reduced early childhood exposure to poliovirus, which paradoxically led to a decline in population-wide herd immunity and created conditions for more frequent and severe polio epidemics.
How did improvements in 19th-century sanitation paradoxically affect polio epidemics?
Answer: They reduced early childhood exposure, causing a decline in population-wide herd immunity and more severe epidemics.
Explanation: Improvements in 19th-century sanitation reduced early childhood exposure to poliovirus, which paradoxically led to a decline in population-wide herd immunity and created conditions for more frequent and severe polio epidemics.
What cultural change was spurred by the polio epidemics, as mentioned in the source?
Answer: The rise of grassroots fund-raising campaigns for medical philanthropy.
Explanation: The polio epidemics spurred profound cultural changes, including the rise of grassroots fund-raising campaigns that revolutionized medical philanthropy and the emergence of the modern field of rehabilitation therapy.
What is World Polio Day, and when is it observed?
Answer: An annual day of awareness observed on October 24th, commemorating Jonas Salk's birth.
Explanation: World Polio Day is an annual day of awareness observed on October 24th, established by Rotary International to commemorate the birth of Jonas Salk, who developed the first polio vaccine.