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Question 1
Correct
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Which of the following is the primary host for Toxoplasma Gondii?
Your Answer: Cats
Explanation:Toxoplasma gondii, an intracellular protozoan, is the main causative agent for Toxoplasmosis. The primary host for the organism is the domestic cat. Humans can become infected by eating undercooked meat of animals harbouring cysts, consuming water or food contaminated with cat faeces, or through maternal-fetal transmission. Toxoplasmosis can cause complications in pregnancy such as miscarriages and congenital infection can lead to hydrocephalus, microcephaly, mental disability and vision loss.
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This question is part of the following fields:
- Microbiology
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Question 2
Correct
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Which group of beta haemolytic streptococci is associated with chorioamnionitis?
Your Answer: B
Explanation:Chorioamnionitis is a complication of pregnancy caused by bacterial infection of the fetal amnion and chorion membranes. Group B Streptococcus is associated with chorioamnionitis
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This question is part of the following fields:
- Microbiology
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Question 3
Correct
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Which HPV subtypes are chiefly associated with causing cancer?
Your Answer: 16 and 18
Explanation:HPV 16 and 18 are responsible for 70% of cases of HPV related cancers. They are considered the most important high risk genotypes of HPV. As well as cervical cancer they are associated with cancers of the oropharynx and anogenital region.
There are over 100 genotypes of HPV including several other high risk HPV types. Gardasil® is a quadrivalent vaccine against HPV Types 6, 11, 16, and 18
HPV genotypes 6 and 11 are low risk and cause anogenital warts.
Typically 70% of HPV infections are cleared within 1 year and 90% are cleared within 2 years
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This question is part of the following fields:
- Microbiology
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Question 4
Incorrect
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A 29 year old women wants to speak to you regarding infections in pregnancy. Her two year old son has sensorineural deafness as a result of infection in her previous pregnancy. She tells you he was born with a 'blueberry muffin' rash. What was the most likely infection?
Your Answer: CMV
Correct Answer: Rubella
Explanation:The ‘Blueberry muffin’ rash is a descriptor for the rash seen in Congenital Rubella Syndrome. A similar petechial rash may also occur in CMV infection but shouldn’t be termed ‘blueberry muffin’
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This question is part of the following fields:
- Microbiology
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Question 5
Correct
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Rubella belongs to which of the following family of viruses?
Your Answer: Togaviruses
Explanation:The Rubella virus, also known as German measles, is found in the Togavirus family and is a single-stranded RNA virus. The virus, which is acquired through contact with respiratory secretions, primarily replicates in the nasopharynx and lymph nodes, and produces a mild and self-limiting illness. Congenital infection, however, is associated with several anomalies including sensorineural deafness, cataracts and cardiac abnormalities.
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This question is part of the following fields:
- Microbiology
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Question 6
Correct
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What is the incidence of listeriosis in pregnancy?
Your Answer: 1 in 10,000
Explanation:The incidence of listeria infection in pregnant women is estimated at 12 per 100 000 compared to 0.7 per 100 000 in the general population.
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This question is part of the following fields:
- Microbiology
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Question 7
Correct
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HPV genotypes 6 and 11 are associated with which of the following?
Your Answer: Low grade squamous intraepithelial lesions of the cervix (LSIL)
Explanation:HPV types 6 and 11 are associated with low risk, low grade squamous intraepithelial lesion. While types 16,18,31 and 33 are associated with high risk, high grade neoplasia.
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This question is part of the following fields:
- Microbiology
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Question 8
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A 30 year old women comes to see you and advises she has felt a little unwell with diarrhoea and flu like symptoms. She is 28 weeks pregnant. Upon questioning she discloses she ate a soft cheese and deli meats platter 5 days earlier. A blood culture confirms listeria infection. What is the appropriate treatment (she has no known drug allergies)?
Your Answer: Amoxicillin
Explanation:The diagnosis of listeria depends on clinical suspicion and isolation of the organism from blood, vaginal swabs or the placenta. Meconium staining of the amniotic fluid in a preterm foetus may increase clinical suspicion for listeriosis. For women with listeriosis during pregnancy, intravenous antibiotic treatment (ampicillin 2 g given every 6 hours) is indicated.
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This question is part of the following fields:
- Microbiology
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Question 9
Incorrect
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A 24 year old woman presents to the clinic with foul smelling vaginal discharge. Which facultative anaerobic bacteria is most likely to be the cause?
Your Answer: Neisseria gonorrhoeae
Correct Answer: Gardnerella vaginalis
Explanation:Bacterial vaginosis is a common infection of the vagina caused by the overgrowth of atypical bacteria, most commonly Gardnerella vaginalis, a gram indeterminate bacteria, which is also a facultative anaerobe. Patients often complain of foul-smelling fishy discharge and dysuria. In diagnosing BV, a swab is taken for microscopy, often revealing clue cells. Of the other organisms listed in the options, Neisseria is an obligate anaerobe, while Chlamydia trachomatis is an obligate intracellular aerobe. Treponema Pallidum is an aerophilic bacteria and Mycoplasma hominis is a pleomorphic parasitic bacterium.
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This question is part of the following fields:
- Microbiology
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Question 10
Correct
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Question 11
Incorrect
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Question 12
Incorrect
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You see a 23 year old women in clinic with cervicitis. Which gram negative intracellular organism is most likely to be responsible?
Your Answer: Gardnerella vaginalis
Correct Answer: Chlamydia trachomatis
Explanation:Chlamydia trachomatis (D-K subtypes) is the most common cause in this age group and fits the descriptors given.
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This question is part of the following fields:
- Microbiology
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Question 13
Correct
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During a speculum examination, a lady was found to have a firm, 12mm ulcerated, indurated lesion on her cervix. She was otherwise asymptomatic. Most likely cause would be?
Your Answer: Treponema pallidum
Explanation:This lady is most likely suffering from primary syphilis. Since the chancre is asymptomatic, it is often only found on deep examination of the vulvo-vaginal mucosa. The chief organism causing syphilis is Treponema Pallidum which is a spirochete and one of the most widely distributed sexually transmitted infections.
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This question is part of the following fields:
- Microbiology
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Question 14
Incorrect
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Herpes Simplex is which type of virus
Your Answer: double stranded RNA
Correct Answer: double stranded DNA
Explanation:Herpes simplex is a double stranded DNA virus. There are two viral types, HSV-1 and HSV-2. The majority of orolabial infections are caused by HSV-1. These infections are usually acquired during childhood through direct physical contact such as kissing. Genital herpes is a sexually transmitted infection and is most commonly caused by HSV-2.
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This question is part of the following fields:
- Microbiology
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Question 15
Correct
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You are asked to see a 26 year old patient following her first visit to antenatal clinic. She is 9 weeks pregnant and bloods have shown her to be non-immune to Rubella. She is concerned about congenital rubella syndrome (CRS). What is the most appropriate advice to give?
Your Answer: Advise vaccination after birth regardless of breast feeding status
Explanation:Congenital rubella infection that occurs after 16 weeks gestation does not typically cause fetal abnormalities. This however plays no part in vaccination advice. Rubella vaccine is live and should not be given during pregnancy. The mother should be offered vaccination after giving birth. It is safe for the vaccine (typically given as combined MMR) to be administered if the mother is breastfeeding.
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This question is part of the following fields:
- Microbiology
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Question 16
Incorrect
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A 32 year old patient develops painful ulcerated genital lesions and inguinal lymphadenopathy. She is 32 weeks pregnant. You suspect genital herpes and send swabs. Which of the following is appropriate management according to the 2014 BASHH/RCOG guidelines?
Your Answer: Give Acyclovir 400mg TDS orally for 5 days
Correct Answer: Send bloods to check antibody status. If this supports this is a first episode genital HSV then patient should be advised to have C-section delivery
Explanation:Although acyclovir should be given, this patient is in the 3rd trimester so the course should continue until delivery. Dose will be 400mg TDS unless disseminated disease. If this is a primary HSV infection (This should be confirmed by lesion swabs to confirm HSV infection and bloods to check no antibody response i.e. evidence previous infection) then C-section is indicated.
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This question is part of the following fields:
- Microbiology
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Question 17
Correct
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HPV genotypes 6 and 11 are associated with which of the following?
Your Answer: Low grade squamous intraepithelial lesions of the cervix (LSIL)
Explanation:6 and 11 are considered low risk and are commonly associated with genital warts and low-grade squamous intraepithelial lesions of the cervix (can correspond cytologically to CIN 1)
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This question is part of the following fields:
- Microbiology
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Question 18
Incorrect
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A 29 year old patient who is 15 weeks pregnant comes to see you. She currently has chickenpox. She is concerned her baby may get congenital fetal varicella syndrome (FVS). What would you advise her the risk of this is?
Your Answer: 10.00%
Correct Answer: 2.00%
Explanation:FVS has been reported to complicate maternal chickenpox that occurs as early as 3 weeks and up to 28 weeks of gestation. The risk appears to be lower in the first trimester (0.55 per cent). No case of FVS has been reported when maternal infection has occurred after 28 weeks.
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This question is part of the following fields:
- Microbiology
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Question 19
Correct
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A 32 year old mother is in her first trimester of pregnancy with her second child. She is worried about infections in this pregnancy as her daughter was born with a 'blueberry muffin rash' and was soon found to have sensorineural deafness due to an infection. Which of the following infections is most likely?
Your Answer: Rubella
Explanation:Congenital infections can be the cause of various congenital abnormalities. Infection with the Rubella virus, part of the TORCH infections (toxoplasmosis, other organisms, rubella, cytomegalovirus, and herpes simplex), can lead to cardiac abnormalities, ophthalmic defects, sensorineural deafness and neurodevelopmental delays. At birth congenital rubella syndrome presents with a petechial rash characteristically dubbed a blueberry muffin rash, and hepatosplenomegaly with jaundice. Immunization of the mother against measles is an effective way of reducing the occurrence of congenital rubella syndrome.
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This question is part of the following fields:
- Microbiology
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Question 20
Incorrect
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You are asked to explain to a patient the results of her Rubella screen. They are as follows:
Your Answer: Patient susceptible to Rubella
Correct Answer: Acute Rubella Infection
Explanation:IgM rise is typically seen with acute infection. IgG is produced in response to infection but is produced later than IgM. IgG is also produced in response to vaccination. If IgG and IgM are negative the patient is susceptible to Rubella infection. If IgG +ve and IgM -ve the patient should be considered immune. If IgM +ve this suggests acute infection or false positive IgM (not uncommon)
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This question is part of the following fields:
- Microbiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
