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  • Question 1 - A 13-year-old girl and her mother visit the GP to discuss the HPV...

    Incorrect

    • A 13-year-old girl and her mother visit the GP to discuss the HPV vaccine, Gardasil. The mother has concerns and wants to know which strains of HPV the vaccine targets.

      Your Answer: HPV 16 and 18

      Correct Answer:

      Explanation:

      Understanding the Different Strains of HPV and Their Association with Cervical Cancer

      Human papillomavirus (HPV) is a common sexually transmitted infection that can lead to various health issues, including cervical cancer. However, not all strains of HPV are equally dangerous. Here is a breakdown of some of the most common strains and their association with cervical cancer:

      HPV 16 and 18 are the most concerning strains as they have the strongest association with cervical cancer. In fact, 70% of cervical cancers are caused by these two strains. This is why the HPV vaccination programme targets these strains.

      HPV 1 and 2 are associated with warts on the feet and hands, respectively, and are not strongly linked to cervical cancer.

      HPV 45 is a rare strain, and the current HPV vaccine provides protection against HPV 6, 11, 16, and 18 strains.

      HPV 31 and 33 are linked to cervical intra-epithelial neoplasia and have a high correlation with genital and oral cancers, but their link to cervical cancer is not as strong as HPV 16 and 18.

      HPV 52 and 58 are also linked to cancer, but their association with cervical cancer is not as strong as HPV 16 and 18.

      Understanding the different strains of HPV and their association with cervical cancer is crucial in preventing and managing this disease. Regular cervical cancer screenings and getting vaccinated against HPV can help reduce the risk of developing cervical cancer.

    • This question is part of the following fields:

      • Microbiology
      7.5
      Seconds
  • Question 2 - A patient presents with diarrhoea and vomiting; she is jaundiced. Hepatitis A infection...

    Correct

    • A patient presents with diarrhoea and vomiting; she is jaundiced. Hepatitis A infection is diagnosed.
      Which one of the following modes of transmission is most likely?

      Your Answer: Contaminated food

      Explanation:

      Modes of Transmission for Hepatitis A Virus

      Hepatitis A virus is a self-limiting RNA virus that causes hepatitis. It is primarily acquired orally through contaminated food or water, or through contact with the feces of an infected individual. The incubation period is between two and six weeks, and symptoms may include flu-like and gastrointestinal symptoms during the prodromal phase, and jaundice, pruritus, fatigue, and hepatomegaly during the icteric phase. Unlike hepatitis B, C, D, and E, hepatitis A does not cause chronic infection and usually confers lifelong immunity.

      Mosquitoes and ticks do not transmit hepatitis A, but different mosquito species act as vectors for diseases such as malaria, dengue, chikungunya, and yellow fever, while hard and soft ticks transmit rickettsial infections like Rocky Mountain spotted fever. Hepatitis B, C, and D can be transmitted sexually, and hepatitis B, C, D, and E can be transmitted through blood transfusion. In rare cases, hepatitis A may also be transmitted sexually.

      Understanding the Modes of Transmission for Hepatitis A Virus

    • This question is part of the following fields:

      • Microbiology
      26.8
      Seconds
  • Question 3 - A 16-year-old girl, originally from India, has been exhibiting behavioural problems at school....

    Correct

    • A 16-year-old girl, originally from India, has been exhibiting behavioural problems at school. After a few months, she started experiencing involuntary movements of her limbs and is now having tonic-clonic seizures. A diagnosis of subacute sclerosing panencephalitis has been confirmed through an EEG. Which infectious agent is likely to be detected in her cerebrospinal fluid (CSF) antibodies?

      Your Answer: Measles

      Explanation:

      Subacute Sclerosing Panencephalitis: A Rare Complication of Measles

      Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder caused by the measles virus and is a rare complication of measles. It typically occurs 5-10 years after the initial measles infection. The diagnosis of SSPE is based on clinical symptoms such as behavioural changes, myoclonus, dementia, and visual disturbances, along with the presence of characteristic periodic EEG discharges called Rademecker complexes, and a raised antibody titre against measles in the plasma and cerebrospinal fluid.

      Treatment for SSPE involves lifelong oral isoprinosine and intraventricular interferon. However, if the patient does not respond, SSPE usually causes death within 1-3 years. The best way to prevent SSPE is through vaccination against measles.

      Other viral infections such as mumps, rubella, varicella zoster, and malaria are not associated with SSPE. Cerebral malaria may present with an unarousable coma, which is unlikely to be seen in SSPE until the very end stage of the disease.

    • This question is part of the following fields:

      • Microbiology
      39
      Seconds
  • Question 4 - A 62-year-old woman came to the clinic with complaints of abdominal bloating and...

    Incorrect

    • A 62-year-old woman came to the clinic with complaints of abdominal bloating and diarrhea for the past week. She was especially bothered by frequent passing of gas. She had recently returned from a trip to India where she was involved in missionary work. There was no presence of blood in her stool. Additionally, she reported experiencing mild nausea. She had no history of abdominal surgery and was not taking any medications. What is the recommended course of treatment?

      Your Answer: Oral rehydration therapy only

      Correct Answer: Metronidazole, 400 mg three times daily (tid) for 5 days

      Explanation:

      If a person has not followed proper food hygiene while traveling in the Indian subcontinent, they may develop infectious diseases. Symptoms such as bloating, belching, and flatulence suggest acute Giardia infection, which can lead to chronic infection and malabsorption if left untreated. The recommended treatment is metronidazole 400 mg three times daily for five days. Tinidazole 2 g single-dose therapy is also effective, but three days of treatment are excessive. Albendazole 400 mg is used to treat intestinal helminth infections. Oral rehydration therapy is suitable for viral or toxin-mediated diarrhea, but it is not the first choice. If left untreated, chronic infection may persist, so any suspected episode of giardiasis should be treated.

    • This question is part of the following fields:

      • Microbiology
      28.9
      Seconds
  • Question 5 - A 45-year-old woman with human immunodeficiency virus (HIV) is hospitalized due to dehydration...

    Correct

    • A 45-year-old woman with human immunodeficiency virus (HIV) is hospitalized due to dehydration caused by chronic diarrhea. What is the most frequently identified pathogen in cases of chronic diarrhea linked to HIV?

      Your Answer: Cryptosporidium

      Explanation:

      Common Causes of Diarrhoea in Immunocompromised Patients

      Immunocompromised patients, particularly those with HIV infection, are at increased risk of developing chronic diarrhoea. Among the causative organisms, Cryptosporidium is the most commonly isolated. This intracellular protozoan parasite can cause severe debilitating diarrhoea with weight loss and malabsorption in HIV-infected patients. Treatment involves fluid rehydration, electrolyte correction, and pain management, with the initiation of highly active antiretroviral therapy (HAART) being crucial for restoring immunity.

      Salmonella, Isospora belli, Campylobacter, and Shigella are other common causes of diarrhoea in immunosuppressed patients. Salmonella infection typically occurs after eating uncooked foods such as chicken, while Isospora species can also cause diarrhoea but not as commonly as Cryptosporidium. Campylobacter infection can present with a flu-like prodrome, fever, and in severe cases, bloody diarrhoea and severe colitis. Treatment often involves quinolones, but one complication to be wary of is the subsequent development of neurological symptoms due to Guillain–Barré syndrome. Shigella infection typically presents with bloody diarrhoea after ingestion of the toxin.

    • This question is part of the following fields:

      • Microbiology
      10.7
      Seconds
  • Question 6 - A 35-year-old man visits his General Practitioner to receive the results of an...

    Correct

    • A 35-year-old man visits his General Practitioner to receive the results of an HIV test, which come back positive. What test would be the most helpful in determining his likelihood of developing an opportunistic infection (OI)?

      Your Answer: CD4 count

      Explanation:

      Diagnostic Tests for HIV-Related Immune Impairment

      The CD4 count is a reliable indicator of HIV-related immune impairment. In HIV-negative individuals, the CD4 count is usually maintained above 600-800 cells/µl. Without antiretroviral therapy (ART), HIV-positive individuals will experience a gradual decline in CD4 count. A CD4 count of <350 cells/µl is associated with an increased risk of opportunistic infections (OI), while a count of <200 cells/µl indicates an 80% risk of developing an OI over the next three years. Chest X-rays are usually normal in HIV-positive individuals without a history of chronic respiratory disorders. Blood cultures may be useful in diagnosing the presence of an OI, but will not help estimate the risk of developing OIs. HIV-positive individuals often have an abnormal full blood count (FBC), being at higher risk of anaemia, lymphopenia, and thrombocytopenia. However, these abnormalities may be for a variety of reasons and do not help with risk assessment for developing OIs. Tuberculin skin tests (TST) are used to check for immunity to tuberculosis (TB) and in the diagnosis of latent TB infection (LTBI). HIV-positive individuals are at a much higher risk of TB disease, but may also have a muted response to TST due to their compromised immunity. TST can be useful in assessing a patient’s eligibility for treatment with isoniazid preventive therapy but is not useful in assessing disease stage and risk of OIs in general. Diagnostic Tests for HIV-Related Immune Impairment

    • This question is part of the following fields:

      • Microbiology
      6.1
      Seconds
  • Question 7 - How would you describe a small RNA genome delta antigen virus that can...

    Correct

    • How would you describe a small RNA genome delta antigen virus that can only exist alongside hepatitis B?

      Your Answer: Hepatitis D

      Explanation:

      Hepatitis D and Human Cytomegalovirus

      Hepatitis D is a virus that can only exist alongside another virus, specifically hepatitis B. Patients who are infected with both viruses have a higher risk of developing severe liver conditions such as hepatic failure, cirrhosis, and cancer. The mortality rate for those with both viruses is 20%, and it is more common in under-developed countries and among intravenous drug users.

      On the other hand, Human Cytomegalovirus (CMV) is a type of herpes virus that can remain latent in the body for many years. While a normal individual may not experience any symptoms, CMV can be life-threatening for those with weakened immune systems. HIV seropositive patients are unlikely to develop CMV disease unless their CD4 counts are less than 50. Diagnosis of CMV is typically done through whole blood CMV PCR.

      Overall, both hepatitis D and CMV are viruses that can have severe consequences for those who are infected, particularly for those with weakened immune systems. It is important to take preventative measures and seek medical attention if symptoms arise.

    • This question is part of the following fields:

      • Microbiology
      9
      Seconds
  • Question 8 - A 14-year-old boy with a history of sickle cell disease complains of worsening...

    Incorrect

    • A 14-year-old boy with a history of sickle cell disease complains of worsening pain in his left thigh and has a fever. An X-ray of the femur shows bone alterations indicative of osteomyelitis.
      What is the probable infectious agent responsible for this condition?

      Your Answer: Group B streptococci

      Correct Answer: Salmonella enteritidis

      Explanation:

      Understanding the Causative Organisms of Osteomyelitis in Different Patient Populations

      Osteomyelitis is a complex condition that can be caused by a variety of organisms. In patients with sickle cell disease, salmonella enteritidis is the second most common causative organism, due to decreased immunity to encapsulated organisms. Staphylococcus aureus remains the most common causative organism overall. Gram-negative organisms, such as pseudomonas aeruginosa, are more commonly found in intravenous drug users and asplenic patients. Group B streptococci is a common causative agent in newborns, while proteus mirabilis is a rare causative organism in osteomyelitis. Escherichia coli is more commonly found in osteomyelitis occurring in asplenic patients and intravenous drug users. Diagnosis of osteomyelitis is complex and requires a combination of high clinical suspicion, raised inflammatory markers, and appropriate imaging investigations. Prolonged antibiotic therapy is often needed to successfully treat osteomyelitis, and early involvement of orthopaedic surgeons is useful, particularly in cases of chronic osteomyelitis.

    • This question is part of the following fields:

      • Microbiology
      26.6
      Seconds
  • Question 9 - A pediatric hospital adopts a set of infection management practice guidelines developed within...

    Correct

    • A pediatric hospital adopts a set of infection management practice guidelines developed within the local community. If the medical staff follows these guidelines, what is the expected outcome?

      Your Answer: Stable antibiotic susceptibility patterns for bacteria

      Explanation:

      The Benefits of Guideline Use in Antibiotic Treatment

      Guideline use in antibiotic treatment has been linked to stable antibiotic susceptibility patterns in both Gram positive and Gram negative bacteria. This is thought to be due to the promotion of antimicrobial heterogeneity. Additionally, guideline use has been associated with a decrease in overall antibiotic use and a reduction in the use of inadequate treatment regimens. These factors could potentially impact the development of antibiotic resistance. The use of automated guidelines has also been shown to decrease adverse drug effects and improve antibiotic selection. Overall, the use of guidelines in antibiotic treatment can have numerous benefits for both patients and the healthcare system.

    • This question is part of the following fields:

      • Microbiology
      14.1
      Seconds
  • Question 10 - A 45-year-old woman recently had a UTI, which was found to be positive...

    Incorrect

    • A 45-year-old woman recently had a UTI, which was found to be positive for Proteus mirabilis. What type of renal calculi is she now at a higher risk for developing?

      Your Answer: Calcium oxalate and calcium phosphate (mixed)

      Correct Answer: Magnesium ammonium phosphate

      Explanation:

      Proteus mirabilis is a type of Gram-negative bacilli that can cause serious infections and is treated with broad-spectrum penicillins or cephalosporins. These organisms produce ureases, which can hydrolyze urea to ammonia and create an alkaline environment in urine. This can lead to the formation of magnesium ammonium phosphate stones, also known as struvite and staghorn calculi. However, Proteus mirabilis is not a risk factor for other types of kidney stones, such as urate, calcium oxalate, calcium phosphate, or cystine stones. These types of stones are caused by different factors, such as dehydration, hypercalcaemia, or genetic conditions. Treatment for each type of stone varies and may involve pain relief, medication, or surgery.

    • This question is part of the following fields:

      • Microbiology
      11.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (6/10) 60%
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