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Question 1
Incorrect
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What is the mode of spread of chickenpox?
Your Answer: Close contact
Correct Answer: Airborne
Explanation:Chickenpox is a highly communicable viral disease caused by human (alpha) herpesvirus 3 (varicella-zoster virus, VZV). It is transmitted from person to person by direct contact (touching the rash), droplet or air born spread (coughing and sneezing).
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This question is part of the following fields:
- Infectious Diseases
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Question 2
Correct
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An 80-year-old female presents to OPD with itching hands, elbows, axillae and groin. Other members residing with her at the retirement home also have similar complaints. Which of the following is the most likely diagnosis?
Your Answer: Scabies
Explanation:Scabies is due to an infestation of Sarcoptes scabiei and most commonly presents with these symptoms. The organism resides in burrows in a pattern specifically affecting the interdigital spaces and the skin folds of the arms and legs. The infection spreads from one person to another, especially in populated communities, through close contact.
Henoch-Schönlein purpura is a type of vascular inflammation.
Psoriasis rash is characterised by scaly plaques affecting the extensor surfaces of the body. Pemphigus vulgaris and bullous pemphigoid both are bullous disorders of the skin. They may present as crusted, weeping, diffuse lesions and there may be involvement in other sites; erosions in the mouth are typically involved in pemphigus vulgaris. Bullous pemphigoid involves the flexural areas and may be associated with a new medication. -
This question is part of the following fields:
- Infectious Diseases
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Question 3
Incorrect
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A 48-year-old male patient presents with fever and signs of delirium. A few hours ago, blisters appeared on his trunk. His past history revealed nothing serious and he's not on any medication. He admits that he went to Italy five months ago on vacation. What is the most probable diagnosis?
Your Answer:
Correct Answer: Chicken pox
Explanation:Chicken pox in adults may manifest with acute encephalitis, causing the confusional syndrome known as delirium. Blisters on the trunk favour the diagnosis. The trip to Italy however seems unimportant since the incubation period of chicken pox is 10 to 21 days.
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This question is part of the following fields:
- Infectious Diseases
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Question 4
Incorrect
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A 17-year-old man presents with fever and extensive preauricular swelling on the right side of his face. However, tenderness is present bilaterally. He also complains of acute pain and otalgia on the right aspect of the face. What is the most likely diagnosis?
Your Answer:
Correct Answer: Mumps
Explanation:Mumps presents with a prodromal phase of general malaise and fever. On examination there is usually painful parotid swelling which has high chances of becoming bilateral. In OM with effusion there are no signs of infection and the only symptom is usually hearing loss. Acute otitis externa produces otalgia as well as ear discharge and itching. Acute OM produces otalgia and specific findings upon otoscopy. In acute mastoiditis the patient experiences ear discharge, otalgia, headache, hearing loss and other general signs of inflammation.
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This question is part of the following fields:
- Infectious Diseases
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Question 5
Incorrect
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A woman presents with several painful ulcers on her vulva. What do you think has most likely caused this?
Your Answer:
Correct Answer: HSV
Explanation:Genital herpes is a sexually transmitted disease (STD). This STD causes herpetic sores, which are painful blisters (fluid-filled bumps) that can break open and ooze fluid.
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This question is part of the following fields:
- Infectious Diseases
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Question 6
Incorrect
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A 25-year-old pregnant mother who is known to have hepatitis B gave birth to a male infant. She is now concerned about her child contracting hep B. Which of the following is the most suitable option for the baby in this case?
Your Answer:
Correct Answer: HepB full vaccine and Ig
Explanation:Hepatitis B full vaccine and Ig should be given to babies born to hepatitis B positive mothers. Hepatitis B vaccine alone or Ig alone is not sufficient to prevent the infection in the new-born baby.
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This question is part of the following fields:
- Infectious Diseases
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Question 7
Incorrect
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A 36-year-old man is scheduled to start on interferon-alpha and ribavirin for the treatment of hepatitis C. His past history includes intravenous drug usage. Which are the most common side effects of interferon-alpha?
Your Answer:
Correct Answer: Depression and flu-like symptoms
Explanation:Adverse effects due to IFN-alpha have been described in almost every organ system. Many side-effects are clearly dose-dependent. Taken together, occurrence of flu-like symptoms, haematological toxicity, elevated transaminases, nausea, fatigue, and psychiatric sequelae are the most frequently encountered side effects.
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This question is part of the following fields:
- Infectious Diseases
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Question 8
Incorrect
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If a patient has HIV what is the most likely cause of persistent watery diarrhoea?
Your Answer:
Correct Answer: Cryptosporidium
Explanation:When you have a patient with HIV and diarrhoea on the exam, think Cryptosporidium. In those who are immunocompetent this organism doesn’t usually cause symptoms, but in immunocompromised people like those with HIV, it causes infection and diarrhoea. Typically those with CD4 counts of <100 cells/µL1 have the greatest risk for prolonged, severe, or extraintestinal cryptosporidiosis.
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This question is part of the following fields:
- Infectious Diseases
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Question 9
Incorrect
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A 33-year-old lady who is known hepatitis C positive comes to your clinic. She is 28 weeks pregnant and her obstetrician wants you to assess her and provide medical advice for the mother and child.
Which of the following statements concerning hepatitis C are most accurate in her case?Your Answer:
Correct Answer: Breast-feeding does not increase the risk of transmission
Explanation:Breast feeding has not been shown to increase the risk of transmission of HCV from mother to baby. This is simply a fact to memorize. The other answer choices are not the most accurate as there is no evidence-proven way to decrease the chance that baby will get HCV from the mother during the birth. About 5 out of every 100 infants born to HCV infected mothers become infected.
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This question is part of the following fields:
- Infectious Diseases
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Question 10
Incorrect
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A 45-year-old female presented with weight loss, night sweats and abdominal pain for 6 months. Abdominal ultrasound scan showed a tubo-ovarian mass. What is the most likely organism, which is responsible for this presentation?
Your Answer:
Correct Answer: Mycobacterium tuberculosis
Explanation:Constitutional symptoms such as weight loss, evening pyrexia and night sweats are associated with Mycobacterium Tuberculosis (TB). TB can affect any system of the body and should be top in the list of differentials particularly if the patient has a history of contact with a known TB patient.
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This question is part of the following fields:
- Infectious Diseases
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Question 11
Incorrect
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A health professional plans to visit Brazil but has recently come to know that there is epidemic of West Nile virus there. Regarding the virus, which of the following is true?
Your Answer:
Correct Answer: May be associated with poliomyelitis-like paralysis
Explanation:West Nile virus is an RNA virus transmitted by the Culex species of mosquitoes. It is mostly prevalent in South America, Africa and some parts of Europe. Clinically it presents with high grade fever, headache, abdominal pain, anorexia and a morbilliform rash over the body. It can also lead to meningitis, encephalitis and flaccid paralysis by affecting the anterior horn cells, a process suggesting similarity to poliomyelitis. It can be fatal if not treated abruptly. Studies suggest that it can be transferred from mother to offspring. New-borns may present with encephalitis, chorioretinitis and wide spread brain damage. Patients suffering from West Nile virus can be effectively treated with interferon, IV immunoglobulin and Ribavirin.
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This question is part of the following fields:
- Infectious Diseases
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Question 12
Incorrect
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Regarding Giardia Lamblia which one of the following statements is true?
Your Answer:
Correct Answer: May cause intestinal malabsorption
Explanation:Giardiasis also known as travellers diarrhoea is caused by Giardia lamblia, which is an anaerobic parasite affecting the small intestine. It can lead to diarrhoea, flatulence, abdominal cramps, malodourous greasy stools and intestinal malabsorption. It can also cause bloody diarrhoea. The investigation of choice is stool examination for trophozoites and cysts. It is treated by metronidazole and tinidazole as first line therapies.
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This question is part of the following fields:
- Infectious Diseases
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Question 13
Incorrect
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Which of the following is true of Koplik's spots?
Your Answer:
Correct Answer: Are diagnostic of measles
Explanation:Koplik’s spots are pathopneumonic for MEASLES. They are blue/white spots, small, occurring on the buccal mucosa. They typically occur next to premolars, not opposite to the incisors. They are not related to fever height. They are not on the hands. They usually occur BEFORE the rash.
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This question is part of the following fields:
- Infectious Diseases
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Question 14
Incorrect
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A 40-year-old male returning from an African country, presented with lower abdominal pain and haematuria. Bladder calcifications were detected on abdominal x-ray. Which of the following is the most probable cause?
Your Answer:
Correct Answer: Schistosoma haematobium
Explanation:Schistosoma haematobium characteristically causes urinary tract disease. S.mansoni, S. mekongi, S. intercalatum, and S. japonicum cause intestinal tract and liver disease.
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This question is part of the following fields:
- Infectious Diseases
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Question 15
Incorrect
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A 4-year-old boy admitted with fever for 2 days had a left sided focal fits, which persisted for 4 minutes. There was no history of head injury. On examination, he was drowsy but there were no focal neurological signs. Urine dipstick was negative. What is the investigation of choice that can be done at this stage to arrive at a diagnosis?
Your Answer:
Correct Answer: CSF analysis
Explanation:This presentation could be due to either a meningitis or encephalitis, which are clinically not distinguishable from the given history. Encephalitis is mostly viral and in UK herpes simplex virus is the main cause. Advanced neuro imaging and EEG will help to differentiate them however from the given answers CSF analysis is the most appropriate, provided that intracranial pressure is not raised. CSF analysis will help to differentiate a pyogenic meningitis from other forms of meningitis and encephalitis.
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This question is part of the following fields:
- Infectious Diseases
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Question 16
Incorrect
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A 19-year-old male presented with a fever and fatigue. On examination, he had multiple lesions on his back and abdomen in various forms. Which of the following is the most probable diagnosis?
Your Answer:
Correct Answer: Varicella zoster
Explanation:Patients with varicella zoster infection present with general fatigue and fever along with multiple lesions which do not appear to be identical.
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This question is part of the following fields:
- Infectious Diseases
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Question 17
Incorrect
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Regarding neonatal meningitis, which of the following statements is true?
Your Answer:
Correct Answer: Has an above average incidence in babies with a meningomyelocele
Explanation:The commonest time for bacterial meningitis is in the 1st month of life and group B Streptococcus is the commonest organism. The anterior fontanelle is full, but does not bulge with normal flexion. Neurological manifestations include seizures, irritability, poor tone, lethargy and tremors, however no findings of sensorineural deafness have been noted. One of the risk factors for introduction of meningeal infection is Meningomyelocele.
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This question is part of the following fields:
- Infectious Diseases
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Question 18
Incorrect
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Sensorineural deafness is strongly associated with which one of the following?
Your Answer:
Correct Answer: Rubella
Explanation:Primary rubella infection during pregnancy, particularly during the first trimester, can affect several organs and cause birth defects that are responsible for congenital rubella syndrome (CRS). The most common defects of CRS are hearing impairment (unilateral or bilateral sensorineural), eye defects (e.g., cataracts, congenital glaucoma, or pigmentary retinopathy), and cardiac defects (e.g., patent ductus arteriosus or peripheral pulmonic stenosis). Congenital hearing loss is the most common sequela, occurring in approximately 60% of cases, especially when infection occurs in the 4th month of pregnancy.
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This question is part of the following fields:
- Infectious Diseases
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Question 19
Incorrect
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A new-born male is admitted to NICU with convulsions, limb hypoplasia and rudimentary digits. Which of the following is the most likely cause?
Your Answer:
Correct Answer: Varicella
Explanation:Infection of chickenpox in the first half of pregnancy can result in congenital varicella syndrome. It presents as cerebral, cortical and cerebellar hypoplasia with convulsions and rudimentary digits. Prevention is by administering varicella vaccine, even before pregnancy. Varicella immunoglobulin is administered to pregnant women who are exposed to infection. Infection during pregnancy is treated with acyclovir.
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This question is part of the following fields:
- Infectious Diseases
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Question 20
Incorrect
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A 30-year-old male presented with a history of bloody and mucoid diarrhoea since that morning. He is also complaining of abdominal spasm and bloating. Which of the following investigations is the most suitable one in this case?
Your Answer:
Correct Answer: Stool culture and sensitivity
Explanation:In a case of sudden bloody and mucoid diarrhoea, stool culture and sensitivity are required to access which organism is causing the problem and to discuss appropriate antibiotics.
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This question is part of the following fields:
- Infectious Diseases
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Question 21
Incorrect
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Which of the following vaccines do not contain live organisms?
Your Answer:
Correct Answer: Polio (Salk)
Explanation:Live virus vaccines include: Vaccinia (smallpox), Measles, Mumps, Rubella (MMR combined vaccine), Varicella (chickenpox), Influenza (nasal spray), Rotavirus, Zoster (shingles) and Yellow fever. Inactivated vaccines are Polio (IPV), Hepatitis A and Rabies.
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This question is part of the following fields:
- Infectious Diseases
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Question 22
Incorrect
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A 35-year-old female presented with complaints of earache and a high-grade fever. During examination, numerous small vesicles were found within the ear canal and her ear is very tender. Which one of the following organisms is most likely to be responsible for such a condition?
Your Answer:
Correct Answer: Herpes zoster
Explanation:Herpes zoster is a viral disorder in which painful vesicular lesions are present in a specific dermatome area. High-grade fever may present as well due to infection. Varicella zoster, measles, herpes simplex and HIV do not present with tender lesions of a limited area.
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This question is part of the following fields:
- Infectious Diseases
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Question 23
Incorrect
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An 18-year-old woman has been diagnosed with human papillomavirus infection. What is the most significant long-term risk following this infection?
Your Answer:
Correct Answer: Cervical cancer
Explanation:Human-papilloma virus (HPV) can lead to cervical cancer. There are many different types, but the types associated with cervical cancer most commonly are 16, 18, 31, 33, and 35. The vaccination against HPV protects against the most common types of HPV that are seen in cervical cancer and is recommended for children/young teens. Cervical cancer has a clear association with HPV, making this the best answer over all of the other answer choices.
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This question is part of the following fields:
- Infectious Diseases
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Question 24
Incorrect
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A keratitis with dendritic ulceration of the cornea is diagnosed in a 32-year-old patient. What is the most likely cause?
Your Answer:
Correct Answer: Herpes simplex virus
Explanation:The dendritic ulceration seen on fluorescein staining of the eye is pathopneumonic for keratitis caused by HSV (herpes simplex virus). Presentation is that of blepharoconjunctivitis. Treatment is required, the treatment is typically topical acyclovir. Topical steroids can make the infection worse. The other answer choices would not have this dendritic pattern seen on fluorescein staining.
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This question is part of the following fields:
- Infectious Diseases
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Question 25
Incorrect
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A 4-year-old girl presents to the clinic with sore throat and a small painful ulcer in her mouth since yesterday and small painful ulcers on palms and soles that are not itchy. She is febrile (38.5 degree Celsius) and is refusing to eat for the past two days. Which of the following will be the most likely cause of this presentation?
Your Answer:
Correct Answer: Coxsackie virus
Explanation: -
This question is part of the following fields:
- Infectious Diseases
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Question 26
Incorrect
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A 32-year-old man notices a pruritic scaly annular rash on his thigh. He claims that the rash appeared after a walk in the park. Which drug would you suggest he starts?
Your Answer:
Correct Answer: Doxycycline
Explanation:The clinical picture of an itchy, scaly annular rash after a walk in the park suggests erythema migrans. The pathogen responsible is a spirochete, Borrelia Burgdorferi transmitted by ticks leading to Lyme disease. Doxycycline is the antibiotic of choice if no contraindications.
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This question is part of the following fields:
- Infectious Diseases
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Question 27
Incorrect
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A urine culture of a 50-year-old patient with urosepsis has isolated a multi-drug resistant Escherichia coli. What is the most likely reason for the multidrug resistance?
Your Answer:
Correct Answer: Extended spectrum beta-lactamase (ESBL) production
Explanation:Extended-spectrum beta-lactamases (ESBL) are enzymes that confer resistance to most beta-lactam antibiotics, including penicillins, cephalosporins, and the monobactam aztreonam. Extended spectrum beta-lactamase (ESBL) production is the main reason for multi-drug resistance among E.coli. Commonly used medications to treat ESBL-involved infections include carbapenems (imipenem, meropenem, and doripenem), cephamycins (cefoxitin and cefotetan), Fosfomycin, nitrofurantoin, beta-lactamase inhibitors (clavulanic acid, tazobactam, or sulbactam), non-beta-lactamases and colistin (if all other medications have failed.)
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This question is part of the following fields:
- Infectious Diseases
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Question 28
Incorrect
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Which of the following procedures does not require antibiotic prophylaxis?
Your Answer:
Correct Answer: Dental procedure for a patient with an atrial septal defect
Explanation:According to latest NICE guidelines, patients with isolated atrial septal defects do not require prophylactic antibiotics originally used in prevention of infective endocarditis in dental procedures.
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This question is part of the following fields:
- Infectious Diseases
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Question 29
Incorrect
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Which of the following is the most common route of hepatitis B transmission worldwide?
Your Answer:
Correct Answer: Perinatal transmission
Explanation:Perinatal transmission is the most common cause of Hepatitis B infection worldwide. Post-exposure prophylaxis should be provided, which consists of hepatitis B immune globulin and hepatitis B vaccine within 12 hours of birth. Without this, about 40% will develop chronic infection.
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This question is part of the following fields:
- Infectious Diseases
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Question 30
Incorrect
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A 25-year-old female presented with blisters on the tongue. Some of them secreted pinkish fluid while some were crusted. Which of the following is the most probable diagnosis?
Your Answer:
Correct Answer: HSV1
Explanation:The history is suggestive of acute gingivostomatitis, which is a manifestation of primary HSV-1 infection. Patients present with gingivitis and vesicular lesions which develop on the oral mucosa, tongue, and lips and later rupture and coalesce, leaving ulcerated plaques.
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This question is part of the following fields:
- Infectious Diseases
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