-
Question 1
Correct
-
A 72-year-old woman who presented with headache and neck stiffness was started on IV ceftriaxone after undergoing a lumber puncture. The CSF culture shows listeria monocytogenes. What is the treatment of choice?
Your 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
-
-
Question 2
Incorrect
-
Which of the following vaccines do not contain live organisms?
Your Answer: Polio (Sabin)
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 3
Incorrect
-
A paediatrician has concerns that a 6-month-old baby is deaf. His mom gives history of having had a sore throat, fever and lymphadenitis during pregnancy. Which organism may be responsible for causing deafness in her infant?
Your Answer: Group B Streptococcus
Correct Answer: Cytomegalovirus (CMV)
Explanation:CMV is a common viral infection that can be transmitted from a pregnant woman to her unborn child, leading to congenital CMV infection. Congenital CMV infection can result in a range of symptoms and complications in newborns, including deafness. In fact, CMV is one of the leading causes of non-genetic sensorineural hearing loss in children.
Given the mother’s history of symptoms during pregnancy and the concern for deafness in the infant, CMV should also be considered as a potential cause.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 4
Correct
-
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: 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
-
-
Question 5
Correct
-
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: 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
-
-
Question 6
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:
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
-
-
Question 7
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 8
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
-
-
Question 9
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
-
-
Question 10
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).
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 11
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 12
Incorrect
-
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 13
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
-
-
Question 14
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 15
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 16
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 17
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 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
-
-
Question 18
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
-
-
Question 19
Incorrect
-
A 10-month-old boy is brought to clinic. His parents are concerned because two days ago, he met another child with mumps. Which is the most appropriate strategy for this child?
Your Answer:
Correct Answer: Do nothing now but give MMR at the appropriate age
Explanation:Immunity against mumps develops over a long time. There is nothing to be done except to proceed with the usual vaccination schedule.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 20
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:
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
-
SESSION STATS - PERFORMANCE PER SPECIALTY
