Monday, 2 November 2015

Tricky Infectious Diseases Objective Type Questions And Answers

71- Which of the following is correct regarding human varicella zoster immunoglobulin (VZIG)?
1) Is used to treat severe chicken pox infection
2) Is recommended for all patients with eczema exposed to chickenpox.
3) Is invariably protective against severe varicella.
4) Should be given to a 14 day old whose mother has developed chickenpox
5) Should be given to a 20 week pregnant non-immune female who has been exposed to a case of chicken pox.

72- Which of the following is a contraindication to immunisation?
1) Infantile eczema requiring topical steroids.
2) Oral poliomyelitis vaccine to a child on oral steroids.
3) A history of prolonged jaundice.
4) A child with congenital adrenal hyperplasia on oral cortisone.
5) A child with cerebral palsy.

73- Which of the following statements is correct of hepatitis C virus infection?
1) Cell cultures of virus are routinely used to assess response to drug therapy
2) High antibody titres are an indication for therapy
3) Less than 5% of cases lead to chronic infection
4) More likely to be transmitted by the sexual route than hepatitis B virus
5) Treatment with ribavirin and interferon alpha is more effective than interferon alpha alone

74- In the diarrhoea associated with cholera toxin, there is activation of which of the following enzyme systems?
1) Adenylate cyclase.
2) ATP.
3) Guanylate cyclase.
4) Na-glucose co-transporter.
5) Na+/K+ ATPase pump.

75- Regarding diphtheria which of the following statments is correct?
1) It is predominantly spread from cutaneous lesions.
2) It is characterised by an inflammatory exudate forming a greyish membrane on the buccal mucosa.
3) It produces a toxin which affects the myocardium, nervous and adrenal tissues.
4) 3 doses of toxoid provides 75% protection.
5) About 50 cases per year are seen in the UK.

76- Which of the following is true of BCG vaccination?
1) is contraindicated in neonates
2) is a killed polysaccharide antigen vaccine
3) should be given to all children who have a strongly positive tuberculin test
4) is presently routinely offered in the UK at age 16 years
5) Provides protection against leprosy

77- Which of the following micro-organisms is generally sensitive to Benzylpenicillin?
1) Bordetella pertussis
2) Cryptococcus neoformans
3) Mycoplasma pneumoniae
4) Streptococcus Pneumonaie
5) Streptococcus Viridans

78- A-30-year-old man developed a febrile illness three days after returning from a holiday in Thailand. He was admitted complaining of severe myalgia. On examination he was febrile (39?C) with a diffuse macular rash on the trunk. There was no lymphadenopathy.
Investigations revealed:
Haemoglobin 15.1 g/dL (13.0-18.0)
White cell count 7.5 x 109/L (4-11)
Platelet count 105 x 109/L (150-400)
Serum total bilirubin 18 ┬Ámol/L (1-22)
Serum alanine aminotransferase 120 U/L (5-35)
What is the most likely diagnosis?
1) Acute HIV infection (seroconversion illness)
2) Dengue fever
3) Hepatitis E
4) Secondary syphilis
5) Typhoid

79- Primary Pulmonary tuberculosis:
1) Leads to pleural effusion
2) Is highly infective
3) Commonly leads to military TB
4) May be totally asymptomatic
5) Usually produces cavitation

80- A 54-year old woman was admitted with acute breathlessness. On examination she had a temperature of 37.9oC, a respiratory rate of 32 breaths per minute, a pulse of 120 beats per minute, a blood pressure of 100/60 mmHg, and a peak expiratory flow rate of 250 litres per minute.
Auscultation of the heart and chest was normal.
The Chest X-ray was normal and
blood gases on air showed:
pH 7.35 (7.36 - 7.44)
Pa02 6.0
kPa (11.3 - 12.6)
PaC02 3.9
kPa (4.7 - 6.0)
Serum bicarbonate 20 mmol/l (20 - 28)
She was started on high flow oxygen. What is the most important next treatment?
1) amoxycillin intravenously
2) aminophylline intravenously
3) intravenous fluids
4) low molecular weight heparin
5) nebulised salbutamol

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