-
Question 1
Incorrect
-
Which of the following is correct regarding toxoplasmosis?
Your Answer: Prophylactic immunoglobulins should be given to pregnant women if their IgM anti-toxoplasma antibodies detected
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 2
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 and he had a booster tetanus shot 3 years ago. In relation to tetanus prevention, select the most suitable management step.
Your Answer: I.M 0.5 ml tetanus toxoid should be administered as single dose
Correct Answer: No action is required
Explanation:The most suitable management step for tetanus prevention in this scenario would be to ensure that the individual receives a tetanus toxoid-containing vaccine if they have not had a booster dose within the last five years. Tetanus toxoid-containing vaccines are routinely given during childhood immunization schedules, but booster doses are recommended every 10 years thereafter to maintain immunity. Since the individual’s immunization history is up to date, if they have received their primary series of tetanus vaccinations and a booster dose within the last five years, no further action would be needed regarding tetanus prevention.
However, if the individual’s immunization status is uncertain or if it has been more than five years since their last tetanus booster, they should receive a tetanus toxoid-containing vaccine promptly. Additionally, if the wound is contaminated or considered high risk for tetanus infection, tetanus immune globulin (TIG) may also be administered for immediate protection against tetanus toxins.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 3
Incorrect
-
A 3 month old infant born to an HIV positive mother presents with jaundice, epileptic seizures and microcephaly. The most likely cause will be?
Your Answer: Rubella
Correct Answer: Cytomegalovirus
Explanation:Congenital CMV infection can occur when a pregnant woman is infected with the cytomegalovirus (CMV) and passes the virus to her unborn child. Infants infected with CMV during pregnancy can exhibit a range of symptoms, including jaundice, seizures, and microcephaly (abnormally small head size). These symptoms are consistent with congenital CMV infection.
Given the mother’s HIV-positive status, the infant may have been at increased risk of acquiring other infections, including CMV, due to potential immunodeficiency.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 4
Correct
-
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: 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 5
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: May be associated with poliomyelitis-like paralysis
Correct Answer: Treatment including with interferon, immunoglobulin and Ribavirin is effective
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
-
-
Question 6
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
-
-
Question 7
Incorrect
-
Regarding Giardia Lamblia which one of the following statements is true?
Your Answer: Often causes a bloody diarrhoea
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 8
Incorrect
-
Which of the following drugs is NOT used in the treatment of MRSA?
Your Answer: Rifampicin
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 9
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
-
-
Question 10
Correct
-
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)
Explanation:CMV is a common virus in the herpesvirus family that can cause serious illness in newborns when contracted congenitally from the mother during pregnancy. Congenital CMV infection can lead to various neurological manifestations, including hydrocephaly (enlargement of the fluid-filled spaces within the brain), seizures, and chorioretinitis (inflammation of the retina in the eye). These symptoms can result in significant morbidity and long-term complications for the affected infant.
Other congenital infections such as toxoplasmosis, rubella, herpes simplex virus (HSV), and syphilis can also cause similar symptoms in newborns. However, given the presentation described, CMV is the most likely infectious agent.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 11
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 most likely organism responsible for this condition?
Your Answer: Pseudomonas aeruginosa
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
-
-
Question 12
Incorrect
-
Which of the following is the drug of choice for the treatment of Chlamydia trachomatis infection during pregnancy?
Your Answer: Metronidazole
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 13
Incorrect
-
A keratitis with dendritic ulceration of the cornea is diagnosed in a 32-year-old patient. What is the most likely cause?
Your Answer:
Correct 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
-
-
Question 14
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 15
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
-
-
Question 16
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 17
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
-
-
Question 18
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
-
-
Question 19
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.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 20
Incorrect
-
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:
Correct 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
-
SESSION STATS - PERFORMANCE PER SPECIALTY
