Infectious Diseases Practice Questions

Q: After initiation of DOTS therapy for category-I, when is the first sputum examination done?

2 months of treatment. **Explanation:** Under the National Tuberculosis Elimination Program (NTEP), the monitoring of treatment response for **Category-I (New cases)** is primarily done through follow-up sputum smear microscopy. **Why Option B is correct:** Category-I treatment consists of an **Intensive Phase (IP)** of 2 months (HRZE) followed by a **Continuation Phase (CP)** of 4 months (HRE). The first follow-up sputum examination is scheduled at the **end of the Intensive Phase (2 months)**. This is a critical milestone to assess "sputum conversion" (from positive to negative), which indicates the effectiveness of the treatment and a reduction in the patient's infectivity. **Why other options are incorrect:** * **Option A (1 month):** This is too early to assess microbiological conversion for standard pulmonary TB. * **Option C (4 months):** Under previous guidelines, a smear was done at 4 months, but current protocols emphasize testing at the end of IP (2 months) and at the end of treatment (6 months). * **Option D (6 months):** This is the timing for the **final** sputum examination to declare the patient "Cured." **High-Yield Clinical Pearls for NEET-PG:** * **Follow-up Schedule:** For New cases, sputum is checked at **2 months** (end of IP) and **6 months** (end of CP). * **If Smear is Positive at 2 Months:** In the current NTEP algorithm, if the 2-month smear is positive, the patient is still transitioned to the Continuation Phase, but a **NAAT (CBNAAT/Truenat)** must be performed to rule out Drug-Resistant TB (DR-TB). * **Definition of "Cured":** A patient who was initially smear-positive, completed treatment, and had a negative smear at the end of treatment (6 months) plus at least one previous negative result.

Q: Which of the following are not sexually transmitted infections?

Hepatitis A virus (HAV) and Varicella zoster virus (VZV). **Explanation:** The core concept of this question lies in distinguishing between pathogens primarily transmitted through sexual contact and those transmitted via respiratory or feco-oral routes. **Why Option A is Correct:** * **Hepatitis A Virus (HAV):** It is primarily transmitted via the **feco-oral route** (contaminated food/water). While sexual transmission can occur among men who have sex with men (MSM) due to oral-anal contact, it is not classified as a classic Sexually Transmitted Infection (STI). * **Varicella Zoster Virus (VZV):** This virus causes Chickenpox and Herpes Zoster. It is transmitted via **respiratory droplets** or direct contact with vesicle fluid. It is never classified as an STI. **Analysis of Incorrect Options:** * **Option B (HIV):** HIV is a classic STI, transmitted through blood, semen, and vaginal fluids. * **Option C (HTLV-I):** This retrovirus is transmitted through sexual contact, blood transfusion, and breastfeeding. It is a recognized STI. * **Option D (HPV):** Human Papillomavirus is one of the most common STIs globally, leading to genital warts and cervical cancer. **NEET-PG High-Yield Pearls:** * **Hepatitis & Sex:** Hepatitis B, C, and D are considered STIs (HBV being the most sexually transmissible). Hepatitis A and E are feco-oral. * **Ulcerative vs. Non-Ulcerative STIs:** Remember that Syphilis, Chancroid, and LGV are ulcerative, while Gonorrhea and Chlamydia are typically non-ulcerative. * **VZV Transmission:** VZV is highly contagious via the respiratory route *before* the rash appears. Once lesions crust over, they are no longer infectious.

Q: What is the recommended prophylactic treatment for close contacts of meningococcal meningitis?

Rifampicin. **Explanation:** **1. Why Rifampicin is Correct:** Rifampicin is the drug of choice for the chemoprophylaxis of meningococcal meningitis. The goal of prophylaxis is to eradicate the nasopharyngeal carriage of *Neisseria meningitidis* in close contacts (e.g., household members, daycare contacts, or healthcare workers exposed to respiratory secretions). Rifampicin achieves high concentrations in salivary and respiratory secretions, effectively eliminating the carrier state and preventing secondary cases. The standard adult dose is 600 mg twice daily for 2 days. **2. Why the Other Options are Incorrect:** * **Erythromycin:** While a macrolide, it is not the standard of care for meningococcal prophylaxis as it is less effective at eradicating the nasopharyngeal carrier state compared to Rifampicin. * **Penicillin:** Although Penicillin G is the treatment of choice for the *active disease* (meningococcemia/meningitis), it does not reliably eliminate the nasopharyngeal carriage and therefore is not used for prophylaxis. * **Cephalosporins:** While 3rd generation cephalosporins (like Ceftriaxone) are used for treatment and can be used as an alternative for prophylaxis (via a single IM injection), they are not the primary first-line oral recommendation over Rifampicin in standard guidelines. **3. High-Yield Clinical Pearls for NEET-PG:** * **Alternative Prophylaxis:** If Rifampicin is contraindicated (e.g., pregnancy), **Ciprofloxacin** (500 mg single dose) or **Ceftriaxone** (250 mg IM single dose) are the preferred alternatives. * **Timing:** Prophylaxis should ideally be administered within 24 hours of identifying the index case. * **Side Effect Note:** Warn patients that Rifampicin may turn urine, sweat, and tears orange/red. * **Vaccination:** Chemoprophylaxis is necessary even if the contact has been previously vaccinated, as vaccines do not protect against all serogroups (especially Serogroup B).

Q: World Tuberculosis Day is celebrated on which date?

24th March. **Explanation:** **Correct Option: A (24th March)** World Tuberculosis (TB) Day is observed annually on **March 24th**. This date commemorates the day in **1882** when **Dr. Robert Koch** announced his discovery of *Mycobacterium tuberculosis*, the bacterium that causes tuberculosis. This discovery was a turning point in medical history, paving the way for the diagnosis and treatment of the disease. **Analysis of Incorrect Options:** * **B. 7th April:** This is **World Health Day**, marking the founding anniversary of the World Health Organization (WHO) in 1948. * **C. 22nd April:** This is **Earth Day**, an international event focused on environmental protection. * **D. 1st December:** This is **World AIDS Day**, dedicated to raising awareness of the AIDS pandemic caused by HIV infection. **High-Yield Clinical Pearls for NEET-PG:** * **Etiology:** TB is caused by the *Mycobacterium tuberculosis* complex (Acid-Fast Bacilli). * **National Program:** In India, the program is currently known as the **National Tuberculosis Elimination Program (NTEP)**, formerly RNTCP. * **Goal:** India aims to **eliminate TB by 2025**, five years ahead of the global Sustainable Development Goal (SDG) of 2030. * **Diagnostic Gold Standard:** **CBNAAT (GeneXpert)** is the preferred initial diagnostic test for TB and Rifampicin resistance. * **Public Health Notification:** TB is a **notifiable disease** in India since 2012. * **Nikshay Poshan Yojana:** A central scheme providing ₹500/month nutritional support to TB patients.

Q: According to guidelines for infant care programs addressing lower abdominal pain, what is the color code of the treatment kit?

Yellow. **Explanation:** The question refers to the **Syndromic Management of Sexually Transmitted Infections (STIs) and Reproductive Tract Infections (RTIs)** under the National AIDS Control Programme (NACP). This approach uses standardized color-coded kits to provide immediate treatment based on clinical symptoms rather than waiting for laboratory confirmation. **1. Why Yellow is Correct:** The **Yellow Kit (Kit 6)** is specifically designated for the management of **Lower Abdominal Pain** in women, which clinically indicates **Pelvic Inflammatory Disease (PID)**. It contains a combination of three drugs to cover common pathogens like *N. gonorrhoeae*, *C. trachomatis*, and anaerobes: * **Cefixime** (400 mg, single dose) * **Metronidazole** (400 mg, twice daily for 14 days) * **Doxycycline** (100 mg, twice daily for 14 days) **2. Why other options are incorrect:** * **White (Kit 1):** Used for **Urethral Discharge** (males), Anorectal discharge, or Cervicitis. Contains Azithromycin and Cefixime. * **Green (Kit 2):** Used for **Vaginal Discharge** (Candidiasis/Trichomoniasis/Bacterial Vaginosis). Contains Secnidazole and Fluconazole. * **Grey (Kit 3):** Used for **Genital Ulcer Disease (Non-Herpetic)**. Contains Azithromycin and Benzathine Penicillin. **Clinical Pearls for NEET-PG:** * **Red Kit (Kit 4):** For Genital Ulcers in patients allergic to Penicillin (uses Doxycycline instead). * **Blue Kit (Kit 5):** For Genital Ulcers (Herpetic). Contains Acyclovir. * **Black Kit (Kit 7):** For Inguinal Bubo. Contains Doxycycline and Azithromycin. * **Key Concept:** Syndromic management is cost-effective, ensures same-day treatment, and breaks the chain of transmission in resource-limited settings.

Q: Which of the following statements about hepatitis B is FALSE?

Vertical transmission is more important than horizontal transmission.. **Explanation:** In Hepatitis B (HBV) epidemiology, the mode of transmission varies significantly by region. In **low-prevalence areas** (like India and the West), **horizontal transmission** (via percutaneous/permucosal routes, sexual contact, and contaminated needles) is the primary driver of the epidemic. While vertical (mother-to-child) transmission carries a high risk of chronicity, it is not the most frequent route globally compared to horizontal spread. Therefore, statement A is false. **Analysis of other options:** * **Option B:** HBV is highly infectious. The communicable period is prolonged, lasting throughout the incubation period and the clinical phase. In chronic carriers, the virus can remain communicable for **years or even a lifetime**. * **Option C:** HBsAg (the first marker) typically appears in the blood **2 to 8 weeks before** the onset of jaundice or clinical symptoms, making this statement accurate. * **Option D:** The age of infection is the **strongest predictor of chronicity**. Approximately 90% of infected infants become chronic carriers, compared to only 5–10% of adults. Thus, age directly determines the long-term prognosis. **High-Yield Clinical Pearls for NEET-PG:** * **Incubation Period:** 30–180 days (Average: 75 days). * **First Marker:** HBsAg is the first to appear; **Anti-HBs** indicates immunity (via recovery or vaccination). * **Window Period:** The interval when HBsAg is cleared but Anti-HBs hasn't appeared; **Anti-HBc IgM** is the only diagnostic marker during this phase. * **Infectivity Marker:** **HBeAg** indicates high viral replication and maximum infectivity.

Q: HIV infection is known to be transmitted during all of the following EXCEPT?

Kissing. **Explanation:** The correct answer is **D. Kissing**. HIV (Human Immunodeficiency Virus) is transmitted through specific body fluids, including blood, semen, vaginal secretions, and breast milk. **Why Kissing is the Correct Answer:** Social kissing (dry kissing) does not transmit HIV because the virus is not present in sufficient concentrations in **saliva** to cause infection. While extremely rare, transmission during "deep" or "French" kissing is only theoretically possible if both partners have significant bleeding gums or open sores, allowing direct blood-to-blood contact. In the context of standard medical examinations, kissing is considered a non-transmission route. **Analysis of Incorrect Options:** * **Breast feeding:** This is a known route of **Vertical Transmission** (Post-natal). The risk of transmission via breast milk is approximately 5–20%. * **Child birth:** This is the most common period for vertical transmission (Intra-partum). Transmission occurs through contact with infected maternal blood and vaginal secretions during delivery. * **Heterosexual intercourse:** Globally, this is the **most common mode of transmission**. The risk is higher for the receptive partner due to a larger surface area of mucous membrane exposure. **High-Yield Clinical Pearls for NEET-PG:** 1. **Most common mode of transmission (Global & India):** Heterosexual route. 2. **Highest risk of transmission per act:** Blood transfusion (approx. 90-95%). 3. **Vertical Transmission:** Overall risk without intervention is 15–45%. This can be reduced to <1% with effective Antiretroviral Therapy (ART). 4. **Window Period:** The time between infection and the appearance of detectable antibodies (usually 2–8 weeks). 5. **Rule of Thumb:** HIV is **NOT** transmitted by fomites, insects (mosquitoes), swimming pools, or sharing utensils.

Question 1

After initiation of DOTS therapy for category-I, when is the first sputum examination done?

Accepted Answer

2 months of treatment

Answer

1 month of treatment

Answer

4 months of treatment

Answer

6 months of treatment

Question 2

Which of the following are not sexually transmitted infections?

Accepted Answer

Hepatitis A virus (HAV) and Varicella zoster virus (VZV)

Answer

Human Immunodeficiency Virus (HIV)

Answer

Hepatitis A virus (HAV) and Human T-lymphotropic virus type I (HTLV-I)

Answer

Hepatitis A virus (HAV) and Human Papillomavirus (HPV)

Question 3

What is the recommended prophylactic treatment for close contacts of meningococcal meningitis?

Accepted Answer

Rifampicin

Answer

Erythromycin

Answer

Penicillin

Answer

Cephalosporins

Question 4

World Tuberculosis Day is celebrated on which date?

Accepted Answer

24th March

Answer

7th April

Answer

22nd April

Answer

1st December

Question 5

Which of the following is true for Directly Observed Treatment, Short-course (DOTS)?

Accepted Answer

Treatment is provided under direct supervision

Answer

All patients receive the exact same treatment regimen

Answer

Streptomycin is administered to every patient

Answer

The treatment regimen is administered daily

Question 6

All of the following are the targets of the STOP TB STRATEGY partnership except:

Accepted Answer

Achieve global incidence of TB disease < 1 case per million population per year

Answer

Achieve a diagnosis rate of > 70% and a cure rate of > 85% by 2005

Answer

Reduce prevalence to < 150 per 100,000 population per year by 2010

Answer

Lower deaths to < 1 per 100,000 population per year by 2010

Question 7

According to guidelines for infant care programs addressing lower abdominal pain, what is the color code of the treatment kit?

Accepted Answer

Yellow

Answer

White

Answer

Green

Answer

Grey

Question 8

Which of the following statements about hepatitis B is FALSE?

Accepted Answer

Vertical transmission is more important than horizontal transmission.

Answer

The communicable period lasts for months.

Answer

The virus can be found in the blood 1 month before jaundice appears.

Answer

The age of onset determines the prognosis.

Question 9

In which anatomical location is the tuberculin test typically performed?

Accepted Answer

Ventral aspect of the left forearm

Answer

Dorsum of the left arm

Answer

Dorsum of the right arm

Answer

Ventral aspect of the right forearm

Question 10

HIV infection is known to be transmitted during all of the following EXCEPT?

Accepted Answer

Kissing

Answer

Breast feeding

Answer

Child birth

Answer

Heterosexual intercourse

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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