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  • Question 1 - The following are commonly recognized disease syndromes associated with Clostridium species, except: ...

    Correct

    • The following are commonly recognized disease syndromes associated with Clostridium species, except:

      Your Answer: exfoliative skin rash

      Explanation:

      Clostridium species do not present with an exfoliative skin rash. C. perfringens is a common aetiology in necrotizing infections (gas gangrene) as well as food poisoning, which often also includes diarrhoea. C. difficle causes diarrhoea. C. tetany and C. botulinum have neurotoxins that can lead to paralysis.

    • This question is part of the following fields:

      • Infectious Diseases
      15.4
      Seconds

  • Question 2 - Which of the following vaccines do not contain live organisms? ...

    Correct

    • Which of the following vaccines do not contain live organisms?

      Your 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.

    • This question is part of the following fields:

      • Infectious Diseases
      15.1
      Seconds

  • Question 3 - A keratitis with dendritic ulceration of the cornea is diagnosed in a 32-year-old...

    Correct

    • A keratitis with dendritic ulceration of the cornea is diagnosed in a 32-year-old patient. What is the most likely cause?

      Your 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.

    • This question is part of the following fields:

      • Infectious Diseases
      14.6
      Seconds

  • Question 4 - A 45-year-old woman is HIV positive. She is very concerned that she is...

    Incorrect

    • A 45-year-old woman is HIV positive. She is very concerned that she is at increased risk of cancer. Which one of the following cancers is NOT increased in HIV positive people?

      Your Answer: Seminoma

      Correct Answer: Breast cancer

      Explanation:

      Breast cancer has a lower incidence in HIV positive patients. Seminoma, Hodgkin’s disease, anal cancer, and non-small cell lung cancer are all increased incidence. Memorize this breast cancer fact.

    • This question is part of the following fields:

      • Infectious Diseases
      21.1
      Seconds

  • Question 5 - A baby is born with complications including microcephaly, hepatosplenomegaly and elevated total bilirubin....

    Correct

    • A baby is born with complications including microcephaly, hepatosplenomegaly and elevated total bilirubin. Which of the following is the most likely diagnosis in this case?

      Your Answer: Cytomegalovirus (CMV)

      Explanation:

      CMV infection is usually asymptomatic in adults. However, if the mother is infected for the first time during pregnancy then there is high chances of this infection passing on to the foetus. CMV infection can cause blindness, deafness, learning difficulties, restricted growth etc. Hepatitis B, herpes simplex, syphilis and HIV do not present with these classical signs of CMV infection in new-borns. It is estimated that 10 stillbirths occur in England and Wales every year due to CMV infection. The foetus is most at risk in early pregnancy. There is no effective prevention.

    • This question is part of the following fields:

      • Infectious Diseases
      61
      Seconds

  • Question 6 - An 18-year-old male was diagnosed with meningococcal meningitis, confirmed on lumbar puncture. After...

    Correct

    • An 18-year-old male was diagnosed with meningococcal meningitis, confirmed on lumbar puncture. After 6 months he presents in the infectious clinic with a second episode of meningitis. His past history is clear and he takes no regular medication. Which of the following is most probably deficient?

      Your Answer: C5

      Explanation:

      Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Disease outcome has been related to the severity of the proinflammatory response in the subarachnoid space. The complement system, which mediates key inflammatory processes, has been implicated as a modulator of pneumococcal meningitis disease severity in animal studies. C5 fragment levels in cerebrospinal fluid (CSF) of patients with bacterial meningitis correlated with several clinical indicators of poor prognosis.

    • This question is part of the following fields:

      • Infectious Diseases
      38.3
      Seconds

  • Question 7 - A 25-year-old female presented with multiple small genital ulcers, which are painful following...

    Incorrect

    • A 25-year-old female presented with multiple small genital ulcers, which are painful following a sexual intercourse with an unknown man. Which of the following can be used topically for this presentation?

      Your Answer: Foscarnet

      Correct Answer: Acyclovir

      Explanation:

      The most probable diagnosis is Herpes Simplex infection. Topical Acyclovir can be used in early stages.

    • This question is part of the following fields:

      • Infectious Diseases
      38.9
      Seconds

  • Question 8 - A 40-year-old male returning from an African country, presented with lower abdominal pain...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Infectious Diseases
      24.1
      Seconds

  • Question 9 - Regarding Giardia Lamblia which one of the following statements is true? ...

    Correct

    • Regarding Giardia Lamblia which one of the following statements is true?

      Your 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.

    • This question is part of the following fields:

      • Infectious Diseases
      22.7
      Seconds

  • Question 10 - There are number of diseases that have to be notified to the consultant...

    Incorrect

    • There are number of diseases that have to be notified to the consultant responsible for communicable disease control. Which of the following conditions does not belong to above category?

      Your Answer: Pneumococcal meningitis

      Correct Answer: Pneumococcal pneumonia

      Explanation:

      There are number of diseases that have to be notified to relevant authorities to prevent or reduce their spread. Those conditions include Cholera, Diphtheria, Food poisoning, Infectious bloody diarrhoea, Malaria, Measles, Meningococcal septicaemia, Mumps, Plague, Rabies and Rubella.

    • This question is part of the following fields:

      • Infectious Diseases
      16.1
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  • Question 11 - A health professional plans to visit Brazil but has recently come to know...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Infectious Diseases
      23.1
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  • Question 12 - A paediatrician has concerns that a 6-month-old baby is deaf. His mom gives...

    Incorrect

    • A paediatrician has concerns that a 6-month-old baby is deaf. His mom gives history of her having a sore throat, fever and lymphadenitis during pregnancy. Which organism causes such manifestations?

      Your Answer:

      Correct Answer: Cytomegalovirus (CMV)

      Explanation:

      The best answer is cytomegalovirus. The mother was infected during the pregnancy and the baby has developed cytomegalo-inclusion syndrome. Histologically, it is identified by viral particles surrounded by lysosomes.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 13 - A 32-year-old patient that has just returned from India, complains of dyspnoea. On...

    Incorrect

    • A 32-year-old patient that has just returned from India, complains of dyspnoea. On examination, you notice grey membranes on the uvula and tonsils and a low-grade fever. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Diphtheria

      Explanation:

      Characteristic findings on patients suffering from diphtheria are the grey membrane on the uvula and tonsils together with the low grade fever and dyspnoea. It’s of great importance that the patient has recently been to India where there is a know prevalence.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 14 - A 60-year-old male who has been on IV antibiotics for severe pneumonia developed...

    Incorrect

    • A 60-year-old male who has been on IV antibiotics for severe pneumonia developed profuse, watery, green coloured diarrhoea on the fifth day of antibiotics. What is the organism responsible for this condition?

      Your Answer:

      Correct Answer: Clostridium difficile

      Explanation:

      The most probable cause for diarrhoea is pseudomembranous colitis which is caused by Clostridium difficile. Pseudomembranous colitis is an inflammatory disease of the colon where the antibiotic-induced change in the balance of normal gut flora allows overgrowth of C difficile. Any antibiotic can cause this but the chances are higher with ampicillin, clindamycin, fluoroquinolones, and cephalosporins.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 15 - An 18-year-old prospective medical student is tested for hepatitis B. Her liver tests...

    Incorrect

    • An 18-year-old prospective medical student is tested for hepatitis B. Her liver tests show alanine transaminase (ALT) 120 U/L and serology shows her to be positive for HBsAg, HBcAb and HBeAg, with a viral load of 105 genome equivalents/mL.

      A liver biopsy is reported as showing early fibrosis with evidence of moderate inflammation.

      Which of the following treatments should be offered?

      Your Answer:

      Correct Answer: Interferon alfa 2b

      Explanation:

      Interferon alfa alone, not interferon alfa and ribavirin, has been shown to achieve HBeAg seroconversion for patients with HBeAg-positive chronic hepatitis B.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 16 - A 30-year-old man has been unwell for the last 3 weeks and now...

    Incorrect

    • A 30-year-old man has been unwell for the last 3 weeks and now developed a rash. Chickenpox is diagnosed.
      What is the appropriate treatment?

      Your Answer:

      Correct Answer: Acyclovir

      Explanation:

      You may treat chickenpox with acyclovir if it is commenced within the first 24 hours of the rash’s appearance. Erythromycin, doxycycline, and ampicillin would not help because it’s a viral infection (Varicella) not a bacterial infection.

    • This question is part of the following fields:

      • Infectious Diseases
      0
      Seconds

  • Question 17 - A patient has been diagnosed with multi-drug resistant tuberculosis and is currently being...

    Incorrect

    • A patient has been diagnosed with multi-drug resistant tuberculosis and is currently being treated with rifampicin, isoniazid, and pyrazinamide. He is commenced on streptomycin.
      Which among the following is the most likely neurological side-effect of streptomycin?

      Your Answer:

      Correct Answer: Vestibular damage

      Explanation:

      Vestibular damage is a neurological side effect of streptomycin.

      Streptomycin is an aminoglycoside bactericidal antibiotic. It is used in the treatment of tularaemia and resistant mycobacterial infections.
      The most common neurological side-effect is vestibular damage leading to vertigo and vomiting.
      Cochlear damage is less frequent and results in deafness.
      Other side-effects include rashes, angioneurotic oedema, and nephrotoxicity.

    • This question is part of the following fields:

      • Infectious Diseases
      0
      Seconds

  • Question 18 - A 33-year-old lady who is known hepatitis C positive comes to your clinic....

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 19 - A baby is born to a mother who is known to have chronic...

    Incorrect

    • A baby is born to a mother who is known to have chronic hepatitis B. The mothers latest results are as follows:


      HBsAg Positive
      HBeAg Positive

      What is the most appropriate strategy for reducing the vertical transmission rate?

      Your Answer:

      Correct Answer: Give the newborn hepatitis B vaccine + hepatitis B immunoglobulin

      Explanation:

      The Green Book guidelines report in an active infection (HBeAg+ and HBsAg+) to give the vaccine as well as immunoglobulin. If antibodies are present it is not active infection (anti-Hbe) and then in that case only the vaccine, and no immunoglobulin, would be given. The presence of HBeAg means a person is infectious and can transmit to other people.

    • This question is part of the following fields:

      • Infectious Diseases
      0
      Seconds

  • Question 20 - A 20-year-old boy returning from vacation in India presented with a history of...

    Incorrect

    • A 20-year-old boy returning from vacation in India presented with a history of fever, myalgia, headache and abdominal pain for 4 days duration. He revealed that he had bathed in a river during his vacation. On examination, he had severe muscle tenderness, hypotension (BP - 80/60 mmHg) and tachycardia (140 bpm). What would be the first step in management?

      Your Answer:

      Correct Answer: IV normal saline

      Explanation:

      The history is suggestive of leptospirosis. This is a zoonotic infection caused by a spirochete. As the patient is in shock, resuscitation with IV fluids is the first step in the management. IV antibiotics should be started (Doxycycline or Penicillin) as soon as possible. Other investigations mentioned are important during the management to rule out other possible diagnoses.

    • This question is part of the following fields:

      • Infectious Diseases
      0
      Seconds

  • Question 21 - Which one of the following is true regarding Escherichia coli infection? ...

    Incorrect

    • Which one of the following is true regarding Escherichia coli infection?

      Your Answer:

      Correct Answer: E coli is an important cause of neonatal meningitis

      Explanation:

      Escherichia coli (also known as E. coli) is a gram-negative, facultatively anaerobic, rod-shaped bacterium commonly found in the lower intestine of warm-blooded organisms. Most E. coli strains are harmless, but some serotypes can cause serious food poisoning in their hosts, and are occasionally responsible for product recalls due to food contamination. The harmless strains are part of the normal flora of the gut, and can benefit their hosts by producing vitamin K2, and preventing colonization of the intestine with pathogenic bacteria. Virulent strains can cause gastroenteritis, urinary tract infections, and neonatal meningitis.
      The most common causes of neonatal meningitis is bacterial infection of the blood, known as bacteremia (specifically Group B Streptococci (GBS; Streptococcus agalactiae), Escherichia coli, and Listeria monocytogenes). Although there is a low mortality rate in developed countries, there is a 50% prevalence rate of neurodevelopmental disabilities in E. coli and GBS meningitis

    • This question is part of the following fields:

      • Infectious Diseases
      0
      Seconds

  • Question 22 - A 35-year-old female presented with complaints of earache and a high-grade fever. During...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
      0
      Seconds

  • Question 23 - Sensorineural deafness is strongly associated with which one of the following? ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
      0
      Seconds

  • Question 24 - A 43-year-old female presented with a 5 day history of a productive cough...

    Incorrect

    • A 43-year-old female presented with a 5 day history of a productive cough with rusty coloured sputum. Chest X-ray showed lobar consolidation on her left side. The most likely causative organism would be?

      Your Answer:

      Correct Answer: Streptococcus pneumoniae

      Explanation:

      Streptococcus pneumonia is the chief causative organism for lobar pneumonia in this age group patients. Typically patients present with rusty coloured sputum and a cough. Pneumocystis jiroveci is responsible for causing pneumocystis pneumonia among immunocompromised patients.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 25 - A 36-year-old man is scheduled to start on interferon-alpha and ribavirin for the...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 26 - A 28-year-old male complained of an annular rash following an insect bite he...

    Incorrect

    • A 28-year-old male complained of an annular rash following an insect bite he received during a hiking trip. Which of the following is the drug of choice?

      Your Answer:

      Correct Answer: Doxycycline PO

      Explanation:

      The described rash is the typical rash of erythema migrans of Lyme disease, which is treated by doxycycline PO

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 27 - A 72-year-old woman who presented with headache and neck stiffness was started on...

    Incorrect

    • A 72-year-old woman who presented with headache and neck stiffness was started on IV ceftriaxone after undergoing a lumbar puncture. The CSF culture shows listeria monocytogenes. What is the treatment of choice?

      Your Answer:

      Correct Answer: Change to IV amoxicillin + gentamicin

      Explanation:

      The best option would be the combination of ampicillin and gentamycin. Changing to IV amoxicillin+gentamycin is however the best among the given choices here.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 28 - A 25-year-old pregnant female suddenly developed a rash on her torso. It started...

    Incorrect

    • A 25-year-old pregnant female suddenly developed a rash on her torso. It started as macules and then became vesicles. After 3 days she died. During her post-mortem, positive findings suggestive of pneumonitis were found. Which one of the following is the most common cause?

      Your Answer:

      Correct Answer: Varicella zoster virus (VZV)

      Explanation:

      Varicella zoster virus (VZV) presents in this way and the rash transforms from macules to vesicles. Pneumonitis is a common complication of VZV infection.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 29 - A 19-year-old woman is diagnosed with acute purulent meningitis after returning from a...

    Incorrect

    • A 19-year-old woman is diagnosed with acute purulent meningitis after returning from a recent holiday abroad. Which of the following investigations is the least relevant?

      Your Answer:

      Correct Answer: PCR of CSF for Mycobacterium TB

      Explanation:

      Amoebic, bacterial and fungal meningitis may present acutely but this is not common in tuberculous meningitis. Amoebic meningitis is caused by Naegleria fowleri as a result of swimming in infected freshwater. The organism may be found in fresh CSF specimens with phase contrast microscopy.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 30 - Which of the following procedures does not require antibiotic prophylaxis? ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 31 - A 3 month old infant born to HIV positive mother presented with jaundice,...

    Incorrect

    • A 3 month old infant born to HIV positive mother presented with jaundice, epileptic seizures and microcephaly. The most likely cause will be?

      Your Answer:

      Correct Answer: Cytomegalovirus

      Explanation:

      Congenital cytomegalovirus infection causes; jaundice, hepatosplenomegaly, petechia, microcephaly, hearing loss and seizures.

    • This question is part of the following fields:

      • Infectious Diseases
      0
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  • Question 32 - A 45-year-old male presents to the clinic complaining of vomiting and early morning...

    Incorrect

    • A 45-year-old male presents to the clinic complaining of vomiting and early morning headaches. CT scan of the brain shows multiple ring enhancing lesions. Which of the following is the cause of this finding?

      Your Answer:

      Correct Answer: Toxoplasmosis

      Explanation:

      Toxoplasmosis is a disease caused by the obligate intracellular parasite Toxoplasma gondii. Transmission occurs either through ingestion of cysts found, for example, in raw meat or cat faeces, or from mother to foetus through the placenta.
      The clinical presentation depends on the patient’s immune status: In immunocompetent individuals, 90% of cases are harmless and asymptomatic, with the remaining 10% displaying mild mononucleosis-like symptoms. In immunosuppressed patients (e.g., those who are HIV-positive), infection may result in cerebral toxoplasmosis (headache, confusion, focal neurologic deficits) or toxoplasma chorioretinitis (eye pain, reduced vision).
      Treatment is indicated for immunosuppressed patients, infected mothers, congenital toxoplasmosis, and immunocompetent patients with more severe symptoms. The treatment of choice is usually a combination of pyrimethamine, sulfadiazine, and leucovorin (folinic acid), with the exception of new infections during pregnancy, which are treated with spiramycin.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 33 - A 20-year-old woman who is sexually active is having deep dyspareunia and vaginal...

    Incorrect

    • A 20-year-old woman who is sexually active is having deep dyspareunia and vaginal discharge. She has a negative smear for Gonococcus. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Chlamydial trachomatis

      Explanation:

      This case is highly suggested of PID or Pelvic Inflammatory disease with chlamydia as the more common infective agent. Tetracyclines are used for treatment.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 34 - A 27-year-old woman presents with a 4cm bleeding ulcer on her labia minora....

    Incorrect

    • A 27-year-old woman presents with a 4cm bleeding ulcer on her labia minora. The woman admits she is sexually active. Which lymph nodes will the ulcer drain to?

      Your Answer:

      Correct Answer: Superficial inguinal

      Explanation:

      The woman seems to have a chancroid, which may or may not drain to the lymph nodes of the groin. These nodes are the superficial inguinal lymph nodes.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 35 - A 79-year-old nursing home resident presents to the clinic with an intensely itchy...

    Incorrect

    • A 79-year-old nursing home resident presents to the clinic with an intensely itchy rash. Examination reveals white linear lesions on the wrists and elbows, and red papules on the penile surface. Which of the following will be the most suitable management plan for this patient?

      Your Answer:

      Correct Answer: Topical permethrin

      Explanation:

      Scabies is a parasitic skin infestation caused by Sarcoptes scabiei mite, which is primarily transmitted via direct human-to-human contact. The female scabies mite burrows into the superficial skin layer, causing severe pruritus, particularly at night. Primary lesions commonly include erythematous papules, vesicles, or burrows. Treatment involves topical medical therapy (e.g. permethrin) and decontamination of all clothing and textiles.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 36 - A 15-year-old girl is referred to the paediatric unit with reduced urine output...

    Incorrect

    • A 15-year-old girl is referred to the paediatric unit with reduced urine output and lethargy. She has been passing bloody diarrhoea for the past four days. On admission she appears dehydrated. Bloods show the following:


      Na+ 142 mmol/l
      K+ 4.8 mmol/l
      Bicarbonate 22 mmol/l
      Urea 10.1 mmol/l
      Creatinine 176 µmol/l


      Hb 10.4 g/dl
      MCV 90 fl
      Plt 91 * 109/l
      WBC 14.4 * 109/l

      Given the likely diagnosis, which one of the following organisms is the most likely cause?

      Your Answer:

      Correct Answer: E. coli

      Explanation:

      The likely diagnosis in this case is Haemolytic Uremic Syndrome (HUS), which is generally seen in young children presenting with a triad of symptoms, namely: acute renal failure, microangiopathic haemolytic anaemia, and thrombocytopenia. The typical cause of HUS is ingestion of a strain of Escherichia coli.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 37 - If a patient has HIV what is the most likely cause of persistent...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 38 - A 32-year-old man notices a pruritic scaly annular rash on his thigh. He...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 39 - A 22-year-old female presents with a history of a whitish discharge from her...

    Incorrect

    • A 22-year-old female presents with a history of a whitish discharge from her vagina. She previously underwent a dental procedure and completed a 7 day antibiotic course prior to it. Which of the following microorganisms has most likely lead to this?

      Your Answer:

      Correct Answer: Candida

      Explanation:

      Candida albicans is the most common cause of candidiasis and appears almost universally in low numbers on healthy skin, in the oropharyngeal cavity, and in the gastrointestinal and genitourinary tracts. In immunocompetent individuals, C. albicans usually causes minor localized infections, including thrush (affecting the oral cavity), vaginal yeast infections (if there is an underlying pH imbalance), and infections of the intertriginous areas of skin (e.g., the axillae or gluteal folds). More widespread and systemic infections may occur in immunocompromised individuals (e.g., neonates, diabetics, and HIV patients), with the oesophagus most commonly affected (candida esophagitis). Localized cutaneous candidiasis infections may be treated with topical antifungal agents (e.g., clotrimazole). More widespread and systemic infections require systemic therapy with fluconazole or caspofungin.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 40 - Which of the following is the most common route of hepatitis B transmission...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 41 - A 4-year-old boy admitted with fever for 2 days had a left sided...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 42 - Which one of the following immunological changes is seen in progressive HIV infection?...

    Incorrect

    • Which one of the following immunological changes is seen in progressive HIV infection?

      Your Answer:

      Correct Answer: Increase in B2-microglobulin levels

      Explanation:

      The immunological changes in HIV include depletion in CD4+ T cell, cytokine dysregulation and immune dysfunction. The dominant immunologic feature of HIV infection is progressive depletion of the helper T cell (CD4+ T cell), which reverses the normal CD4:CD8 ratio and subsequently lead to immunodeficiency. Other imuunological changes include:
      increased B2-microglobulin
      decreased IL-2 production
      polyclonal B-cell activation
      decreased NK cell function
      reduced delayed hypersensitivity responses

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 43 - Her parents with a severe headache present a 24-year-old woman. She is afraid...

    Incorrect

    • Her parents with a severe headache present a 24-year-old woman. She is afraid of light and sun and prefers darker environments. On examination, a generalized rash that does not blanch on pressure is noticed. What is the best action in this case?

      Your Answer:

      Correct Answer: IV benzylpenicillin

      Explanation:

      The rash is a characteristic sign of meningitis. Added to photophobia, headache and neck rigidity, meningitis is highly suggested diagnosis. IV antibiotics should be started immediately.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 44 - Hepatitis C is what kind of virus? ...

    Incorrect

    • Hepatitis C is what kind of virus?

      Your Answer:

      Correct Answer: A variable RNA virus

      Explanation:

      Hepatitis C is a single-stranded positive sense RNA virus. It is variable because of the high rate of error of RNA-dependent RNA polymerase and the pressure from the host immune system has caused HCV to evolve and develop seven genetic lineages.

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      • Infectious Diseases
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  • Question 45 - A 45-year-old male patient presents with severe pharyngitis and dysphagia. He's found to...

    Incorrect

    • A 45-year-old male patient presents with severe pharyngitis and dysphagia. He's found to be HIV positive and with oesophageal candidiasis. Which of the following regarding HIV virus is correct?

      Your Answer:

      Correct Answer: HIV is an RNA virus

      Explanation:

      The human immunodeficiency virus (HIV) is grouped to the genus Lentivirus within the family of Retroviridae, subfamily Orthoretrovirinae. The HIV genome consists of two identical single-stranded RNA molecules that are enclosed within the core of the virus particle. The genome of the HIV provirus, also known as proviral DNA, is generated by the reverse transcription of the viral RNA genome into DNA, degradation of the RNA and integration of the double-stranded HIV DNA into the human genome.

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      • Infectious Diseases
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  • Question 46 - A 25-year-old female presented with blisters on the tongue. Some of them secreted...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 47 - A 17-year-old man presents with fever and extensive preauricular swelling on the right...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 48 - Which of the following drugs is NOT used in the treatment of MRSA?...

    Incorrect

    • Which of the following drugs is NOT used in the treatment of MRSA?

      Your Answer:

      Correct Answer: Ceftriaxone

      Explanation:

      Cephalosporins, such as ceftriaxone, do not cover methicillin-resistant staph aureus. They do cover some gram positives and gram negatives. Vancomycin and teicoplanin given intravenously have good coverage of MRSA and other gram positive bacteria. Rifampicin and doxycycline, although not the best treatment, can be used for outpatients if there are no systemic signs of illness.

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      • Infectious Diseases
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  • Question 49 - A homeless woman presented with a cough and fever for the last 3...

    Incorrect

    • A homeless woman presented with a cough and fever for the last 3 months. She also complained of night sweats and weight loss. Her CXR showed lung opacities. What is the next appropriate step for this patient?

      Your Answer:

      Correct Answer: Acid fast bacilli

      Explanation:

      History and CXR are suggestive of tuberculosis. Acid fast bacilli should be seen on microscopy to confirm the diagnosis.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 50 - A 11-year-old girl with a history of recurrent chest infections, was admitted with...

    Incorrect

    • A 11-year-old girl with a history of recurrent chest infections, was admitted with a fever, productive cough, anorexia and weight loss. On examination she was febrile and tachycardic. Her mother said that the girl was not thriving well. Which of the following organisms is responsible for this presentation?

      Your Answer:

      Correct Answer: Pseudomonas

      Explanation:

      History of recurrent infections and failure to thrive (probably due to pancreatic enzyme insufficiency) is highly suggestive of cystic fibrosis. Pseudomonas has been identified as an important respiratory pathogen in patients with cystic fibrosis.

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      • Infectious Diseases
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  • Question 51 - A 34-year-old man presents with haemoptysis and weight loss. History reveals he suffers...

    Incorrect

    • A 34-year-old man presents with haemoptysis and weight loss. History reveals he suffers from night sweats and upon auscultation you notice reduced breath sounds over the apex of his right lung and significant nail clubbing. You refer him to a pneumologist who administers the following antibiotics: rifampicin, ethambutol, pyrazinamide and isoniazid. What is the mechanism of action of the first drug?

      Your Answer:

      Correct Answer: Inhibit RNA synthesis

      Explanation:

      Rifampicin specifically inhibits bacterial RNA polymerase, the enzyme responsible for DNA transcription, by forming a stable drug-enzyme complex with a binding constant of 10(-9) M at 37 C.

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      • Infectious Diseases
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  • Question 52 - A social worker has been diagnosed with hepatitis C infection. Which test will...

    Incorrect

    • A social worker has been diagnosed with hepatitis C infection. Which test will conclusively establish the presence of this infection?

      Your Answer:

      Correct Answer: HCV RNA

      Explanation:

      The most sensitive test for detecting Hepatitis C infection (acute) is HCA RNA; it can be detected 1-2 weeks after infection. Anti-HCV antibodies take at least 6 weeks to develop and be positive.

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      • Infectious Diseases
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  • Question 53 - A 48-year-old male patient presents with fever and signs of delirium. A few...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 54 - A 31-year-old homosexual male is complaining of recent weight loss and blurred vision....

    Incorrect

    • A 31-year-old homosexual male is complaining of recent weight loss and blurred vision. A fundoscope was performed showing retinal haemorrhage. What is the single most appropriate option?

      Your Answer:

      Correct Answer: Cytomegalovirus (CMV)

      Explanation:

      CMV is the best answer . Weight loss is mostly caused by HIV, which commonly presents with retinal haemorrhage and retinopathy when associated with CMV.

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      • Infectious Diseases
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  • Question 55 - A 38-year-old woman returns from a summer holiday with a dry cough. Her...

    Incorrect

    • A 38-year-old woman returns from a summer holiday with a dry cough. Her CXR shows bilateral consolidated areas. Which antibiotic would you suggest?

      Your Answer:

      Correct Answer: Ciprofloxacin

      Explanation:

      Ciprofloxacin is a well-established broad-spectrum fluoroquinolone antibiotic that penetrates well into the lung tissues.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 56 - A 30-year-old male presented with a history of bloody and mucoid diarrhoea since...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 57 - A man was admitted to the hospital and developed varicella zoster after 48h....

    Incorrect

    • A man was admitted to the hospital and developed varicella zoster after 48h. Which of the following categories of people should be administered immunoglobulin only?

      Your Answer:

      Correct Answer: All pregnant women who are tested negative for antibodies.

      Explanation:

      Immunoglobulin should be given to all seronegative women within 4 days. However, it is strongly advised to seek medical care immediately if the disease develops.

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      • Infectious Diseases
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  • Question 58 - A 45-year-old female presented with weight loss, night sweats and abdominal pain for...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 59 - A 32-year-old male has recently had a splenectomy following a motorcycle accident. He...

    Incorrect

    • A 32-year-old male has recently had a splenectomy following a motorcycle accident. He is up to date with all vaccinations which were offered as part of his childhood vaccination scheme. It is July. Which of the following vaccinations does he require in the first instance?

      Your Answer:

      Correct Answer: Pneumococcus, meningococcus type B and C, Haemophilus type B

      Explanation:

      Acquired asplenia or hyposlenia can occur following splenectomy. Hyposplenism is used to describe reduced (‘hypo-‘) splenic functioning and is associated with increased risk of sepsis from polysaccharide encapsulated bacteria. In particular, patients are at risk from Streptococcus pneumoniae, Haemophilus influenzae, and meningococcus. The risk is elevated as much as 350-fold.

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      • Infectious Diseases
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  • Question 60 - A 32-year-old Indian male presents to the clinic with fever, cough and an...

    Incorrect

    • A 32-year-old Indian male presents to the clinic with fever, cough and an enlarged cervical lymph node. Examination reveals a caseating granuloma in the lymph node. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: TB adenitis

      Explanation:

      Tuberculous lymphadenitis is a chronic, specific granulomatous inflammation of the lymph node with caseation necrosis, caused by infection with Mycobacterium tuberculosis or a related bacteria. The characteristic morphological element is the tuberculous granuloma (caseating tubercle).

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      • Infectious Diseases
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  • Question 61 - Which of the following is correct regarding toxoplasmosis? ...

    Incorrect

    • Which of the following is correct regarding toxoplasmosis?

      Your Answer:

      Correct Answer: Can present with fits in patients with AIDS

      Explanation:

      T. gondii infection in immunocompetent people is usually asymptomatic. It can present as fits in patients with AIDs, who are immunosuppressed. Additionally, infection in the first trimester of pregnancy is very harmful. Congenital toxoplasmosis presents with intracranial calcifications, classically. It can also present with hydrocephalus, microcephaly, blindness, petechiae. Siramycin is the drug of choice to try to prevent vertical transmission from mother to baby. It is typically gotten from cat faeces or raw/undercooked meat, not raw eggs (raw eggs: think salmonella).

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      • Infectious Diseases
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  • Question 62 - Regarding neonatal meningitis, which of the following statements is true? ...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 63 - An 8-week-old baby was found to have bilateral cataracts. Further investigation revealed thrombocytopenia,...

    Incorrect

    • An 8-week-old baby was found to have bilateral cataracts. Further investigation revealed thrombocytopenia, a patent ductus arteriosus and hepatosplenomegaly. Which of the following is the most probable diagnosis?

      Your Answer:

      Correct Answer: Rubella

      Explanation:

      The clinical presentation is suggestive of congenital rubella syndrome. The classic triad of presenting symptoms includes sensorineural hearing loss, ocular abnormalities (cataract, infantile glaucoma, and pigmentary retinopathy) and congenital heart disease (patent ductus arteriosus and pulmonary artery stenosis). Other findings in congenital rubella syndrome include CNS abnormalities (mental retardation, behavioural disorders, encephalographic abnormalities, hypotonia, meningoencephalitis, and microcephaly), hepatosplenomegaly, and jaundice.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 64 - A 20-year-old pregnant female in her first trimester met a child with chickenpox....

    Incorrect

    • A 20-year-old pregnant female in her first trimester met a child with chickenpox. She was investigated for the varicella antibody, which came back negative. She visited her GP. Which of the following measures is the most appropriate one?

      Your Answer:

      Correct Answer: Ig

      Explanation:

      After the exposure to chickenpox while pregnant, even if the patient is negative for antibodies she requires immunoglobulin to prevent further issues.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 65 - A woman who is 36 weeks pregnant presents with chickenpox. How should she...

    Incorrect

    • A woman who is 36 weeks pregnant presents with chickenpox. How should she be treated?

      Your Answer:

      Correct Answer: Acyclovir

      Explanation:

      Acyclovir is the correct answer. There has been no documented evidence of harm in pregnancy yet. Chickenpox can cause fetal abnormalities, and varicella zoster Immunoglobulin should be given to the infant immediately after birth (not the mother, won’t help). Steroids will actually make the chicken pox worse. Painkillers only, is obviously the wrong answer and pose severe risk to foetus.

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      • Infectious Diseases
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  • Question 66 - An 18-year-old woman has been diagnosed with human papillomavirus infection. What is the...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 67 - Which of the following is the drug of choice for the treatment of...

    Incorrect

    • Which of the following is the drug of choice for the treatment of Chlamydia trachomatis infection during pregnancy?

      Your Answer:

      Correct Answer: Amoxicillin

      Explanation:

      Tetracycline is not recommended in pregnancy because of the risk to fetal development (bones, teeth!). Metronidazole in pregnancy: currently not thought to be an increased risk in pregnancy; however this is not effective against chlamydia. Amoxicillin is shown to be an adequate treatment for chlamydia, so this is the correct answer.

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      • Infectious Diseases
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  • Question 68 - A 25-year-old pregnant mother who is known to have hepatitis B gave birth...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 69 - Which one of the following congenital infections is most characteristically associated with chorioretinitis?...

    Incorrect

    • Which one of the following congenital infections is most characteristically associated with chorioretinitis?

      Your Answer:

      Correct Answer: Toxoplasma gondii

      Explanation:

      The common congenital infections encountered are rubella, toxoplasmosis and cytomegalovirus. Cytomegalovirus is the most common congenital infection in the UK. Maternal infection is usually asymptomatic.
      Congenital toxoplasmosis is associated with fetal death and abortion, and in infants, it is associated with neurologic deficits, neurocognitive deficits, and chorioretinitis.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 70 - What is the mode of spread of chickenpox? ...

    Incorrect

    • What is the mode of spread of chickenpox?

      Your Answer:

      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).

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 71 - A urine culture of a 50-year-old patient with urosepsis has isolated a multi-drug...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 72 - Which of the following is true of Koplik's spots? ...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 73 - A new-born male is admitted to NICU with convulsions, limb hypoplasia and rudimentary...

    Incorrect

    • 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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      • Infectious Diseases
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  • Question 74 - A woman presents with several painful ulcers on her vulva. What do you...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
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  • Question 75 - A 4-year-old girl presents to the clinic with sore throat and a small...

    Incorrect

    • 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 76 - An 80-year-old female presents to OPD with itching hands, elbows, axillae and groin....

    Incorrect

    • 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:

      Correct 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 77 - Which of the following forms of acute viral hepatitis has a much higher...

    Incorrect

    • Which of the following forms of acute viral hepatitis has a much higher mortality in pregnant than non-pregnant females?

      Your Answer:

      Correct Answer: Hepatitis E

      Explanation:

      Pregnant patient in a third world country with hepatitis: The answer is most likely Hepatitis E. The mortality for Hepatitis E in pregnant women is very high. It is transmitted faecal-orally. There is no hepatitis G. Hepatitis C, B, A are less likely to be the correct answer than E given it’s classic association with pregnancy and poor living conditions.

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      • Infectious Diseases
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  • Question 78 - A 55-year-old lady who a known case of normal pressure hydrocephalus (NPH) presented...

    Incorrect

    • A 55-year-old lady who a known case of normal pressure hydrocephalus (NPH) presented with complaints of weakness in her lower limbs, urinary incontinence and progressively worsening confusion. Which of the following statements is true regarding NPH?

      Your Answer:

      Correct Answer: Is associated with gait disturbance

      Explanation:

      Normal pressure hydrocephalus is a form of communicating hydrocephalus characterised by enlarged ventricles with normal opening pressure on lumbar puncture. For diagnostic purposes, a triad of urinary incontinence, gait abnormality and dementia is necessary. It is necessary to diagnose the condition early because it is reversible by placing a ventriculoperitoneal shunt. It is most common in patients aged more than 60 years.

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      • Infectious Diseases
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  • Question 79 - A 55-year-old woman diagnosed with type 2 diabetes presents with vomiting and diarrhoea...

    Incorrect

    • A 55-year-old woman diagnosed with type 2 diabetes presents with vomiting and diarrhoea after eating a meal of chicken and chips. She said her stool had small amounts of blood in. Campylobacter Jejuni was found on her stool culture exam. Which of the following is the most appropriate therapy?

      Your Answer:

      Correct Answer: IV fluids

      Explanation:

      Campylobacter is the most likely cause of diarrheal illness often due to undercooked meat being ingested. It is also a major cause of traveller’s diarrhoea. Sufficient fluid replacement and anti-emetics are indicated first followed by the antibiotic, Erythromycin although antibiotic treatment in adults is still in question. Ciprofloxacin and Tetracycline may also be effective.

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      • Infectious Diseases
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  • Question 80 - A 34-year-old's chest x-ray showed diffuse bilateral alveolar shadows. He also suffers from...

    Incorrect

    • A 34-year-old's chest x-ray showed diffuse bilateral alveolar shadows. He also suffers from shortness of breath, weight loss and dry cough due to Kaposi's sarcoma but no fever was noted. Which is the most likely causative organism?

      Your Answer:

      Correct Answer: Pneumocystis jiroveci

      Explanation:

      Pneumocystis Jiroveci. This causative organism is responsible for pneumonia in individuals that have a compromised immune system. Symptoms include cyanosis, dry cough and in some cases, diffuse bilateral alveolar shadows on CXR. Co-trimoxazole is normally the treatment for this.

    • This question is part of the following fields:

      • Infectious Diseases
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Infectious Diseases (8/11) 73%
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