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  • Question 1 - 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
      21.2
      Seconds
  • Question 2 - 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: Drug impermeability

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

      Explanation:

      Extended-spectrum beta-lactamases (ESBL) are enzymes that confer resistance to most beta-lactam antibiotics, including penicillins, cephalosporins, and the monobactam aztreonam. Extended spectrum beta-lactamase (ESBL) production is the main reason for multi-drug resistance among E.coli. Commonly used medications to treat ESBL-involved infections include carbapenems (imipenem, meropenem, and doripenem), cephamycins (cefoxitin and cefotetan), Fosfomycin, nitrofurantoin, beta-lactamase inhibitors (clavulanic acid, tazobactam, or sulbactam), non-beta-lactamases and colistin (if all other medications have failed.)

    • This question is part of the following fields:

      • Infectious Diseases
      17.6
      Seconds
  • Question 3 - A 31-year-old homosexual male is complaining of recent weight loss and blurred vision....

    Correct

    • 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: Cytomegalovirus (CMV)

      Explanation:

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

    • This question is part of the following fields:

      • Infectious Diseases
      8.3
      Seconds
  • Question 4 - 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
      13.2
      Seconds
  • Question 5 - A 35-year-old female presented with complaints of earache and a high-grade fever. During...

    Correct

    • 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: 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
      13
      Seconds
  • Question 6 - 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
      13.5
      Seconds
  • Question 7 - A 6-year-old boy with fever and malaise for 2 days recently developed bloody...

    Correct

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

      Your Answer: Escherichia coli 0157

      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
      18.9
      Seconds
  • Question 8 - 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
      21.5
      Seconds
  • Question 9 - Regarding Giardia Lamblia which one of the following statements is true? ...

    Correct

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

      Your Answer: May cause intestinal malabsorption

      Explanation:

      Giardiasis also known as travellers diarrhoea is caused by Giardia lamblia, which is an anaerobic parasite affecting the small intestine. It can lead to diarrhoea, flatulence, abdominal cramps, malodourous greasy stools and intestinal malabsorption. It can also cause bloody diarrhoea. The investigation of choice is stool examination for trophozoites and cysts. It is treated by metronidazole and tinidazole as first line therapies.

    • This question is part of the following fields:

      • Infectious Diseases
      9.4
      Seconds
  • Question 10 - A 20-year-old boy returning from vacation in India presented with a history of...

    Incorrect

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

      Your Answer: IV benzylpenicillin 2.4 g

      Correct Answer: IV normal saline

      Explanation:

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

    • This question is part of the following fields:

      • Infectious Diseases
      2.2
      Seconds
  • Question 11 - Regarding neonatal meningitis, which of the following statements is true? ...

    Incorrect

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

      Your Answer: Is most commonly caused by Haemophilus influenzae

      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
      20.7
      Seconds
  • Question 12 - 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: Mycobacterium TB

      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
      16.5
      Seconds
  • Question 13 - A 72-year-old woman who presented with headache and neck stiffness was started on...

    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
      8.3
      Seconds
  • Question 14 - 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 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
      9.6
      Seconds
  • Question 15 - 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
      11.1
      Seconds
  • Question 16 - In which one of the following diseases does the patient have to be...

    Correct

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

      Your Answer: Measles

      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
      4.6
      Seconds
  • Question 17 - A 45-year-old female presented with weight loss, night sweats and abdominal pain for...

    Correct

    • 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: 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
      8.8
      Seconds
  • Question 18 - 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
      7.8
      Seconds
  • Question 19 - 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
      6.3
      Seconds
  • Question 20 - Which of the following diseases correctly matches the incubation period? ...

    Incorrect

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

      Your Answer: Chicken pox - five to seven days

      Correct Answer: Mumps - 14-18 days

      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
      32.8
      Seconds
  • Question 21 - A 25-year-old pregnant mother who is known to have hepatitis B gave birth...

    Incorrect

    • A 25-year-old pregnant mother who is known to have hepatitis B gave birth to a male infant. She is now concerned about her child contracting hep B. Which of the following is the most suitable option for the baby in this case?

      Your Answer: Nothing until immune status checked

      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
      15.6
      Seconds
  • Question 22 - 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
      28.7
      Seconds
  • Question 23 - A health professional plans to visit Brazil but has recently come to know...

    Correct

    • A health professional plans to visit Brazil but has recently come to know that there is epidemic of West Nile virus there. Regarding the virus, which of the following is true?

      Your Answer: May be associated with poliomyelitis-like paralysis

      Explanation:

      West Nile virus is an RNA virus transmitted by the Culex species of mosquitoes. It is mostly prevalent in South America, Africa and some parts of Europe. Clinically it presents with high grade fever, headache, abdominal pain, anorexia and a morbilliform rash over the body. It can also lead to meningitis, encephalitis and flaccid paralysis by affecting the anterior horn cells, a process suggesting similarity to poliomyelitis. It can be fatal if not treated abruptly. Studies suggest that it can be transferred from mother to offspring. New-borns may present with encephalitis, chorioretinitis and wide spread brain damage. Patients suffering from West Nile virus can be effectively treated with interferon, IV immunoglobulin and Ribavirin.

    • This question is part of the following fields:

      • Infectious Diseases
      26.3
      Seconds
  • Question 24 - 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: Reassurance

      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
      5.9
      Seconds
  • Question 25 - 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: Human tetanus immunoglobulin 250 units should be given

      Correct Answer: No action is required

      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
      4.9
      Seconds
  • Question 26 - There are number of diseases that have to be notified to the consultant...

    Incorrect

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

      Your Answer: Vivax malaria

      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
      7.6
      Seconds
  • Question 27 - A 3 month old infant born to HIV positive mother presented with jaundice,...

    Correct

    • 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

      Explanation:

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

    • This question is part of the following fields:

      • Infectious Diseases
      22.1
      Seconds
  • Question 28 - 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
      5.4
      Seconds
  • Question 29 - 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
      5
      Seconds
  • Question 30 - 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
      28.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Infectious Diseases (19/30) 63%
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