Monday, 2 November 2015

Infectious Diseases Multiple Choice Questions And Answers

21- A 41-year-old African man has a history of multiple episodes of sudden onset of severe abdominal pain and back pain lasting for hours.
Each time this happens, his peripheral blood smear demonstrates numerous sickled erythrocytes.
A haemoglobin electrophoresis shows 94% Hgb S, 5% Hgb F, and 1% Hgb A2. He now has increasing pain in his right groin radiating to the anterior aspect of the thigh and to the knee. His temperature was 38°C and examination of his hip revealed pain on internal rotation. A radiograph reveals irregular bony destruction of the femoral head.
The most likely organism to be responsible for these findings is?
1) Candida albicans
2) Clostridium perfringens
3) Group B streptococcus
4) Salmonella species
5) Yersinia pestis

22- A 35 year old woman with alcoholic cirrhosis is admitted with deteriorating encephalopathy and abdominal discomfort. An ascitic tap revealed a polymorphonuclear cell count of 350 cells per mm3. 
Which of the following is the most appropriate therapy?
1) Intravenous amoxicillin
2) Intravenous cefotaxime
3) Intravenous metronidazole
4) Oral neomycin
5) Oral norfloxacin

23- A 36 year old woman presents with dyspnoea, cough and fever.
Crackles are heard on auscultation of the lungs. Circulating precipitans to Micropolyspora faeni are positive. Which of the following is the most likely diagnosis?
1) Malt workers' lung
2) Pigeon fanciers' lung
3) Allergic Bronchopulmonary Aspergillosis
4) Brucellosis
5) Farmers' lung

24- Which of the following would be indicated in the treatment of a 30 year old HIV positive male with pneumocystis carinii pneumonia? Blood gases reveal a P02 of 55mmHg whilst breathing 28% oxygen.
1) Atovaquone
2) Clindamycin
3) Leucovirin
4) Pentamidine
5) Trimethoprim-sulphamethoxazole

25- Two strains of Escherichia coli are isolated and both are resistant to ampicillin. Strain A retains its resistance to amplicillin when grown form multiple generations in the absence of ampicillin. However strain B loses its resistance when grown in the absence of ampicillin. Which of the following best explains the loss of antibiotic resistance in strain B?
1) Changes in the bacterial DNA gyrase
2) Downregulation of the resistance gene
3) Loss of a plasmid containing the resistance gene
4) Mutations in the resistance gene
5) Transposition of another sequence into the resistance gene

26- A 63 year old patient with known alcohol related cirrhosis presented with ascites, abdominal tenderness and peripheral oedema. A diagnostic tap revealed a neutrophil count of 400/mm3 (normal <250mm3).
Which of the following would be of most immediate benefit?
1) fluid restriction and a no added salt diet
2) intravenous antibiotics
3) oral spironolactone
4) therapeutic paracentesis
5) trans-jugular intrahepatic porto-systemic shunt

27- Which of the following is correct regarding infection with Salmonella typhi
1) children are particularly likely to become carriers
2) most carriers are female
3) faecal culture is almost always positive during the first week of illness
4) relapse does not occur if antibiotics are taken for 2 weeks
5) vaccinated individuals who develop the disease will have a mild illness

28- Which of the following is a true of cutaneous anthrax?
1) causes a black eschar which overlies pus
2) lesions are usually painful and tender
3) lesions are associated with marked oedema
4) Mortality is approximately 20% despite antibiotic therapy
5) Is very likely to occur in subjects exposed to anthrax spores

29- Toxoplasmosis
1) can cause fits in AIDS
2) infection in the first trimester of pregnancy is seldom harmful to fetus
3) undercooked meat is an important cause of infection
4) infection usually by respiration
5) prophylactic immunoglobulins should be given to pregnant women if their IgM anti-toxoplasma antibodies detected.

30- A 26-year-old man with a history of alcohol and drug abuse was admitted with a 14 day history of fever, cough and fatigue. He was emaciated. His temperature was 39.4°C. Cervical and axillary lymphadenopathy were present. Chest X-ray revealed bilateral areas of pulmonary shadowing. Which of the following is the most likely
1) alcoholic cardiomyopathy
2) pneumococcal pneumonia
3) pneumocystis pneumonia
4) pulmonary tuberculosis
5) tricuspid endocarditis

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