INFECTIOUS DISEASES MCQ
1.
A patien patientt is is found found to have have Stre Strepto ptococ coccus cus ovis ovis endoca endocardi rditis tis.. After fter appr appropr opriat iatee tre treat! at!ent ent "ou "ou shou shou#d$ #d$
a. . c. d. e. f. %. h.
CT adrena#s Arran%e denta# revie& revie& Co#onoscop" 'erfor! #ood cu#tures (I) sero#o%" co#onoscop" s!a## o&e# series iron studies
*. A !a#e !a#e in his *+,s *+,s presen presents ts &ith &ith a rash rash over over his his #u! #u!ar ar re%i re%ion. on. -'ho -'hoto to sho& sho&n n &ith &ith #u!a #u!arr )a )arice## rice##aa oster oster/. /. CD0 count found to e 20+3 (I) ve. Most #i4e#" course of disease &ou#d e$ a. . c. d. e.
5ecover" after * &ee4s 'ro#on%ed neura#%ic pain pain Disse!inated cutaneous disease Disse!inated s"ste!ic disease Encepha#opath"
6. advice$ a. . c. d.
(ospi (ospita# ta# &or4er &or4er need#e need#e stic4 stic4 in7ur" in7ur".. 'atien 'atientt (I) (I) ne%ati ne%ative3 ve3 hepati hepatitis tis 8 ne%3 ne%3 (epa (epatit titis is C posi positiv tive. e.
Co!es Co!es for
#a!ivudine if deve#ops hepatitis i!!uno%#ou#in interferon a#p a#ph ha if deve#ops hepatitis #a!ivudine
0. A "oun "oun% % !an !an rece recent nt#" #" retu return rned ed fro! fro! 8ur! 8ur!aa pres presen ents ts ver" ver" un& un&e## e## feri feri#e #e &ith &ith 9CS 9CS of :. 8#oo 8#ood d fi#! fi#! has fa#ciparu! !a#aria. 8est treat!ent$ a. . c. d. e.
;uinine iv ch#oro;uine !ef#o;uine do<"c"c#ine fansidar.
2.
5is4 5is4 of ac;u ac;uir irin in% % fa# fa#ci cipa paru ru! ! !a# !a#ar aria ia is the the %re %reat ates estt in$ in$
a. . c. d. e.
'apua Ne& 9uinea Thai#and Africa India 8ur!a
=.
(S) encepha#itis est dia dia% %nosed &i &ith$
a. . c. d.
#u!ar puncture EE9 ps"cho!etric testin% M5I
:. 'roc 'rocto tosc scop op" " sho sho&n &n in a "oun% oun% &o! &o!an an &it &ith h #o #ood od " diar diarrh rhoe oeaa &ho &ho for for a &ee4 &ee4.. ac4%round !ucosa &ith &ith red and &hite patches. patches. Mana%e!ent>
'ict 'ictur uree sho& sho&ss #ac #ac4 4
a. . c. d.
co#onoscop" MC?S stoo# !etrorndao#e dou#e contrast ariu! ene!a
@. O#der &o!en &ho has as"!pto!atic UTI and has repeat urine sent. %enta!icin3 norf#o
E Co#i %ro&n BCC =+3 sensitive to
oestro%en norf#o
. 'atient &ith co!!on varia#e i!!unodeficienc" presents &ith pneu!onia. or%anis!> a. . c. d. e.
Bhat is the !ost #i4e#"
asper%i##us pneu!ococcus !"cop#as!a CM) 'seudo!onas
1+. 'atient &ith pneu!onia &ho had a fu##" sensitive pneu!ococcus. Da" 2 %ets &orse. C5$ e!p"e!a. Bhat do "ou do> a. . c.
drain e!p"e!a chan%e to er"thro!"cin ronchoscop"
11. A !an spent ti!e in ICU had een on T'N3 had a pancreatic ascess derided3 and no& deve#ops ac4 pain. Una#e to stand3 un&e##3 BCC 163 Neutrophi#s 1+.*3 p#ate#ets 020. ra" sho&n3 #atera# vie& of #u!er spine &ith &ed%in% and so!e process affectin% * ad7acent verterae ->osteo!"e#itis/. Ne a. . c. d. e.
technetiu! one scan %a##iu! scan M5I CT %uided iops" rn"e#o%rarn
1*.
oun% &o!en %oin% to Nepa# for 1* !onths3 &ho is Mantou< ne%ative. 8est advice re !ana%e!ent>
a. . c. d. e.
isoniaid for 1* !onths isoniaid for fevers and s&eats 8C9 vaccine reassure seria# C5
16. (I) positive patient3 s"phi#is treated &ith penici##in in 12. S"phi#is sero#o%" &as 1$=0 then 1$6* then 1$1= then ac4 to 1$6*3 rest of sero#o%" &as positive. 8est !ana%e!ent> a. . c. d.
#u!ar puncture penici##in nothin% repeat sero#o%" in 6 !onths
10.
The MM5 -5ue##a/ vaccine is !ade up of$
a. . c. d. e.
ive attenuated virus Inactivated -4i##ed/ virus 'urified to
12. oun% patient &ith '. fa#ciparu! !a#aria -> fa#ciparu! !ore #i4e#" than viva< or ova#e/. The !ost #i4e#" countr" to have recent#" trave##ed to$ a. . c. d. e.
'apua Ne& 9uinea India Thai#and Gi!a&e >European countr"
1=.
'erson &ith s#ide red ce##s &ith rin% for!s3 so!e &ith !ore than 1 per ce##. Otunded. 8est I) treat!ent$
a. . c. d. e.
Quinine Quinidine Ch#oro;uine Mef#o;uine Do<"c"c#ine
1:. A Streptococcus pneu!oniae is found to have a MIC H1 -hi%h #eve# resistance/. The !ost effective treat!ent &ou#d e$ a. . c. d. e.
'enici##in Ceftria
1@.
8est indicator of pro%ression to AIDS &ith (I) positivit"$
a. . c. d. e.
CD0 count seru! neopterin β* !icro%#ou#in CD@ count (I) vira# titre
1. The treat!ent for adu#t !enin%itis is no& a 6rd %eneration cepha#osporin p#us penici##in. The reason for the addition of penici##in is$ a. . c. d. e.
isteria !onoc"to%enes E. co#i (ae!ophi#us inf#uenae 'enici##inresistant !enin%ococcus 'neu!ococcus
*+. 9onococca# infections can e treated &ith a stat dose of aithro!"cin3 or a ten da" course of do<"c"c#ine. The reason for this difference is> a.
increased seru! ha#f#ife
. c. d. e.
increased intrace##u#ar ha#f#ife postantiiotic effect increased actericida# activit" > increased potenc"
*1.
An (I) patient &ith a CD0 count of 0++ presents &ith a pneu!onia. The !ost #i4e#" or%anis! is$
a. . c. d. e.
Tuercu#osis 'neu!oc"stis carinii At"pica# !"coacteriu! Streptococcus pneu!oniae M"cop#as!a pneu!oniae
**.
The !echanis! of resistance of M5SA to !ethici##in is est characterised "$
a. . c. d. e.
Increased eff#u< of antiiotic fro! the ce## A#tered penici##in indin% proteins Chro!oso!a##" encoded β#acta!ase production Deactivation of the dru% '#as!idencoded β#acta!ase
*6. A fe!a#e schoo#teacher is trave##in% to Nepa# to &or4 for 1* !onths. The est evidence for prevention of tuercu#osis is &ith$ a. . c. d. e.
Isoniaid proph"#a
*0. A nurse receives a need#estic4 in7ur" fro! a patient &ho is found to e (I)ve3 (epatitis 8 ve and (C) ve. Apart fro! fo##o&in% her sero#o%ies "ou shou#d$ a. . c. d. e.
Ad!inister poo#ed hu!an i!!uno%#ou#in 9ive interferon ->&hich one/ 9ive interferon if deve#ops hepatitis Ad!inister #a!ivudine Do nothin% further
*2. An e#der#" %ent#e!an has recent ad!ission for o&e# sur%er"3 and received T'N durin% the ad!ission. (e is read!itted soon after &ith ac4 pain and fevers. -ra" sho&n &ith ovious discitis/. The ne
M5I CT %uided fineneed#e aspirate 8#ood cu#tures 8one scan ANCA
*=. Fe!a#e &ith previous s"phi#is treated > 6 "ears prior. No& as"!pto!atic. 9iven titres and fact that T'(A and FTAAs ve. Titres %iven 1$=03 1$6*3 one 1$1= then fe& 1$6*,s. Ne a. . c. d.
Treat &ith penici##in >IM enathine for * &ee4s u!ar puncture Fo##o& sero#o%" repeat 6 !onths Another penici##in re%i!en
*:.
5e%ardin% intravenous #ines
a. . c. d.
p#astic cannu#ae have a #o&er infection rate than sca#p vein need#es fe!ora# vein cannu#ae have a #o&er infection rate than suc#avian cannu#ae acterae!ia is un#i4e#" to e fro! the intravenous #ine if there is no si%n of ph#eitis in the settin% of acterae!ia cure necessitates re!ova# of the #ine
*@
Urine cu#ture %ro&s J#esie##a pneu!oniae and sho&s the fo##o&in%$
A!o
MIC =0 6* * @ 0
Interpretation resistant resistant sensitive resistant resistant
Treated as a UTI3 re%ardin% therap"3 &hich of the fo##o&in% are true$ a. . c. d.
J#esie##a #i4e#" to e E
*. Indian !an &ith T8. Co!!enced on therap" &ith Etha!uto#3 5ifa!picin3 Isoniaid and '"raina!ide. -Sho&n sensitivities resistant to Isoniaid and Strepto!"cin3 sensitive to others/. This &ou#d indicate$ a. . c. d. e.
pattern of resistance stron%#" su%%estive of prior therap" in India &i## need 0L2* iso#ation short course of 5< not effective second #ine dru%s &i## e needed current therap" &i## not e effective
6+.
Infection co!p#icatin% periphera# cannu#ae is proven to e ↓ "$
a. . c. d. e.
E#ective as opposed to none#ective insertion Ar! vs #e% Anti!icroia# oint!ent Occ#usive dressin% 5esitin% ever" 0@ hours
61. oun% 't in ICU fo##o&in% an M)A. Centra# #ine in situ. Deve#ops fever and air space shado&in% and is treated accordin%#" ->Cefota
5e!ove centra# #ine and send for M3 C ? S ronchoscop" transtrachea# aspirate via ETT Increase antiiotics Echo
6*.
Bhich of the fo##o&in% state!ents re%ardin% M"coacteriu! aviu! co!p#e< -MAC/ disease is INCO55ECT$
a.
On#" 'neu!oc"stis carinii pneu!onia and Japosi,s sarco!a are !ore fre;uent opportunistic diseases affectin% patients &ith AIDS. Mu#tip#e dru% resistance in MAC caused " the !icroe ce## enve#ope
.
c. d. e.
Anti!icroia# proph"#a
