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  • Question 1 - A 25 year old female presented with multiple small genital ulcers, which are...

    Correct

    • 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: 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
      13.6
      Seconds
  • Question 2 - A 19-year-old woman is diagnosed with acute purulent meningitis after returning from a...

    Correct

    • 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: 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
      14.3
      Seconds
  • Question 3 - Which of the following diseases correctly matches the incubation period? ...

    Incorrect

    • Which of the following diseases correctly matches the incubation period?

      Your Answer: Mumps - 14-18 days

      Correct Answer:

      Explanation:

      The incubation periods of disorders is extremely important to diagnose, treat, prevent or attenuate a disease.
      Chickenpox: 7-21 days.
      Whooping cough: 10-14 days.
      Hand, foot and mouth disease: 2-6 days. German measles: 14-21 days.
      Mumps: 14-18 days.

    • This question is part of the following fields:

      • Infectious Diseases
      8.8
      Seconds
  • Question 4 - A 32-year-old patient that has just returned from India, complains of dyspnoea. On...

    Correct

    • 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: 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
      5.3
      Seconds
  • Question 5 - A man was admitted to the hospital and developed varicella zoster after 48h....

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Infectious Diseases
      1149.1
      Seconds
  • Question 6 - 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: Chlamydia trachomatis

      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.

    • This question is part of the following fields:

      • Infectious Diseases
      7.9
      Seconds
  • Question 7 - 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: Clostridium difficile

      Correct Answer:

      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
      10.8
      Seconds
  • Question 8 - 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: Toxoplasmosis

      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
      6.8
      Seconds
  • Question 9 - A health professional plans to visit Brazil but has recently come to know...

    Incorrect

    • 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: Treatment with interferon is effective in West Nile virus encephalitis

      Correct Answer:

      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
      10.5
      Seconds
  • Question 10 - Which of the following is correct regarding toxoplasmosis? ...

    Correct

    • Which of the following is correct regarding toxoplasmosis?

      Your 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
      4.6
      Seconds
  • Question 11 - A 14-day-old baby presented in NICU with the signs and symptoms of hydrocephaly,...

    Incorrect

    • A 14-day-old baby presented in NICU with the signs and symptoms of hydrocephaly, seizures and chorioretinitis. Which of the following infectious agents is most probably the cause in a case like this?

      Your Answer: Cytomegalovirus (CMV)

      Correct Answer: Toxoplasmosis

      Explanation:

      Maternal and fetal toxoplasma infection may be avoided by advising pregnant women to wear gloves when gardening or handling cat litter and to cook meat thoroughly. Affected babies are treated with pyrimethamine, sulfadiazine, and folic acid.

    • This question is part of the following fields:

      • Infectious Diseases
      7.9
      Seconds
  • Question 12 - A 27 year old woman presents with a 4cm bleeding ulcer on her...

    Correct

    • 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: 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
      4.1
      Seconds
  • Question 13 - 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: Varicella zoster virus (VZV)

      Correct Answer:

      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
      120.3
      Seconds
  • Question 14 - There are number of diseases that have to be notified to the consultant...

    Correct

    • 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 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
      12.3
      Seconds
  • Question 15 - A 30-year-old male presented with a history of bloody and mucoid diarrhoea since...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Infectious Diseases
      178
      Seconds
  • Question 16 - Regarding Giardia Lamblia which one of the following statements is true? ...

    Incorrect

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

      Your Answer: May be treated with co-trimoxazole (Septrin)

      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
      21.6
      Seconds
  • Question 17 - 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: Amoxicillin

      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
      18.5
      Seconds
  • Question 18 - A 25-year-old pregnant female suddenly developed a rash on her torso. It started...

    Correct

    • 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: 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
      4.2
      Seconds
  • Question 19 - A 28-year-old male complained of an annular rash following an insect bite he...

    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
      3.4
      Seconds
  • Question 20 - 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: Scabies

      Correct Answer:

      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
      14.1
      Seconds
  • Question 21 - What is the mode of spread of chickenpox? ...

    Correct

    • What is the mode of spread of chickenpox?

      Your 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
      6.9
      Seconds
  • Question 22 - A 32 year old Indian male presents to the clinic with fever, cough...

    Correct

    • 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: 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).

    • This question is part of the following fields:

      • Infectious Diseases
      6.9
      Seconds
  • Question 23 - A 55-year-old woman diagnosed with type 2 diabetes presents with vomiting and diarrhoea...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Infectious Diseases
      8.2
      Seconds
  • Question 24 - A 43 year old female presented with a 5 day history of a...

    Correct

    • 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: 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
      5.9
      Seconds
  • Question 25 - 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: Toxoplasmosis

      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.

    • This question is part of the following fields:

      • Infectious Diseases
      11.1
      Seconds
  • Question 26 - A 16-year-old male fell whilst playing football and was injured by a sharp...

    Incorrect

    • A 16-year-old male fell whilst playing football and was injured by a sharp wooden splinter sustaining a cut to his left shin. His immunisation history is up to date. In relation to tetanus prevention, select the most suitable management step.

      Your Answer: No action is required

      Correct Answer:

      Explanation:

      According to the US immunisation schedule, the child is immunised. So this boy does not need any extra immunisation for tetanus now.

    • This question is part of the following fields:

      • Infectious Diseases
      21.5
      Seconds
  • Question 27 - 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 multi-drug resistance?

      Your Answer: Extended spectrum beta-lactamase (ESBL) production

      Correct Answer:

      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.)

    • This question is part of the following fields:

      • Infectious Diseases
      74.4
      Seconds
  • Question 28 - 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: Ig + vaccine

      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
      10.9
      Seconds
  • Question 29 - Which of the following is the drug of choice for the treatment of...

    Correct

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

      Your 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.

    • This question is part of the following fields:

      • Infectious Diseases
      9.4
      Seconds
  • Question 30 - A 45-year-old woman is HIV positive. She is very concerned that she is...

    Correct

    • 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: 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
      6.6
      Seconds
  • Question 31 - A 6-year-old boy with fever and malaise for 2 days recently developed bloody...

    Incorrect

    • A 6-year-old boy with fever and malaise for 2 days recently developed bloody diarrhoea. What is the most probable aetiology?

      Your Answer: Giardiasis

      Correct Answer:

      Explanation:

      The most likely organism is enterohemorrhagic verotoxin-producing E.coli. It usually causes haemolytic uremic syndrome.
      Crohn’s disease rarely manifests in an acute manner.
      Polio and giardiasis usually manifest with non-bloody diarrhoea.

    • This question is part of the following fields:

      • Infectious Diseases
      8
      Seconds
  • Question 32 - A 17-year-old man presents with fever and extensive pre-auricular swelling on the right...

    Correct

    • A 17-year-old man presents with fever and extensive pre-auricular 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: 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.

    • This question is part of the following fields:

      • Infectious Diseases
      5.5
      Seconds
  • Question 33 - A 34-year-old's chest x-ray showed diffuse bilateral alveolar shadows. He also suffers from...

    Correct

    • 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: 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
      17.9
      Seconds
  • Question 34 - Which of the following vaccines do not contain live organisms? ...

    Incorrect

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

      Your Answer: Typhoid (TY 21a)

      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
      9.6
      Seconds
  • Question 35 - Which of the following drugs is NOT used in the treatment of MRSA?...

    Correct

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

      Your 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.

    • This question is part of the following fields:

      • Infectious Diseases
      4.8
      Seconds
  • Question 36 - 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
      3.2
      Seconds
  • Question 37 - 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: Cytomegalovirus

      Correct Answer:

      Explanation:

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

    • This question is part of the following fields:

      • Infectious Diseases
      8
      Seconds
  • Question 38 - A 48 year old male patient presents with fever and signs of delirium....

    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: Shingles

      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.

    • This question is part of the following fields:

      • Infectious Diseases
      30.8
      Seconds
  • Question 39 - Her parents with a severe headache present a 24-year-old woman. She is afraid...

    Correct

    • 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: 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
      7.2
      Seconds
  • Question 40 - 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: Varicella Zoster immune globulin

      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
      7.6
      Seconds
  • Question 41 - A 25-year-old pregnant mother who is known to have hepatitis B gave birth...

    Correct

    • 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: 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
      19.8
      Seconds
  • Question 42 - An 18-year-old woman has been diagnosed with human papillomavirus infection. What is the...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Infectious Diseases
      4.2
      Seconds
  • Question 43 - 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
      10.5
      Seconds
  • Question 44 - A 19-year-old male presented with a fever and fatigue. On examination, he had...

    Correct

    • A 19-year-old male presented with a fever and fatigue. On examination, he had multiple lesions on his back and abdomen in various forms. Which of the following is the most probable diagnosis?

      Your Answer: Varicella zoster

      Explanation:

      Patients with varicella zoster infection present with general fatigue and fever along with multiple lesions which do not appear to be identical.

    • This question is part of the following fields:

      • Infectious Diseases
      51.2
      Seconds
  • Question 45 - A 11 year old girl with a history of recurrent chest infections, was...

    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: PCP

      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.

    • This question is part of the following fields:

      • Infectious Diseases
      8.3
      Seconds
  • Question 46 - A 55 year old lady who a known case of normal pressure hydrocephalus...

    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: Is not improved by ventriculoperitoneal shunting

      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
      17.2
      Seconds
  • Question 47 - A 32 year old man notices a pruritic scaly annular rash on his...

    Correct

    • 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: 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
      4.3
      Seconds
  • Question 48 - Which of the following procedures does not require antibiotic prophylaxis? ...

    Incorrect

    • Which of the following procedures does not require antibiotic prophylaxis?

      Your Answer: Total hip replacement

      Correct Answer:

      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
      8.6
      Seconds
  • Question 49 - A 10-month-old boy is brought to clinic. His parents are concerned because two...

    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: He should receive MMR plus mumps immunoglobulin now

      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
      7.2
      Seconds
  • Question 50 - 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: Varicella zoster

      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
      8.2
      Seconds
  • Question 51 - A 25 year old female presented with blisters on the tongue. Some of...

    Correct

    • 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: 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
      9.6
      Seconds
  • Question 52 - A homeless woman presented with a cough and fever for the last 3...

    Correct

    • 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: 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
      13
      Seconds
  • Question 53 - 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
      2.9
      Seconds
  • Question 54 - Which of the following is true of Koplik’s spots? ...

    Correct

    • Which of the following is true of Koplik’s spots?

      Your 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.

    • This question is part of the following fields:

      • Infectious Diseases
      5.6
      Seconds
  • Question 55 - Regarding neonatal meningitis, which of the following statements is true? ...

    Correct

    • Regarding neonatal meningitis, which of the following statements is true?

      Your 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
      4.3
      Seconds
  • Question 56 - A 4-year-old boy admitted with fever for 2 days had a left sided...

    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
      4.8
      Seconds
  • Question 57 - 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 lumber puncture. The CSF culture shows listeria monocytogenes. What is the treatment of choice?

      Your Answer: Continue IV ceftriaxone as mono-therapy

      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
      9.2
      Seconds
  • Question 58 - 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: NHL

      Correct Answer:

      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.

    • This question is part of the following fields:

      • Infectious Diseases
      19.2
      Seconds
  • Question 59 - In which one of the following diseases does the patient have to be...

    Incorrect

    • In which one of the following diseases does the patient have to be isolated?

      Your Answer: Measles

      Correct Answer:

      Explanation:

      Measles and chickenpox are spread by droplets. Thus, patients should be isolated.
      Rheumatic fever and post-streptococcal glomerulonephritis are immune mediated diseases that don’t require isolation.
      Herpetic gingivostomatitis spreads by direct transmission of infected secretions to the stratified squamous epithelium.
      HSP is not an infectious disease.

    • This question is part of the following fields:

      • Infectious Diseases
      7.7
      Seconds
  • Question 60 - A 20-year-old boy returning from vacation in India presented with a history of...

    Correct

    • 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 - 80/60mmHg) and tachycardia (140 bpm). What would be the first step in management?

      Your 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
      40
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Infectious Diseases (33/60) 55%
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