Infectious Diseases Practice Questions

Q: A person has presented with history of dog-bite on the uncovered surface of his right leg. There is a minor abrasion without bleeding. Consider the following statements about management : 1. The bite should be taken as a category I contact with suspect animal 2. The bite requires local treatment of the wound 3. The person requires immediate vaccination 4. The person requires immediate administration of rabies immunoglobulin Which of the above statements are correct ?

2 and 3 only. ***2 and 3 only*** - A minor abrasion without bleeding falls under **Category II exposure** per WHO guidelines, requiring **local wound treatment** and **immediate vaccination**. - **Category II exposures** are defined as nibbling of uncovered skin, minor abrasions without bleeding, or scratches without bleeding. *1 and 2* - The bite described (minor abrasion without bleeding) is classified as **Category II exposure** by WHO, not Category I. - **Category I contact** involves touching or feeding an animal, or licks on intact skin, requiring **no post-exposure prophylaxis** as there is no breach of skin integrity. *2, 3 and 4* - While local wound treatment and vaccination are correct for Category II exposure, **rabies immunoglobulin (RIG)** is not indicated for Category II. - RIG is reserved for **Category III exposures**, which involve single or multiple transdermal bites or scratches, contamination of mucous membranes with saliva, or licks on broken skin. *3 and 4 only* - Immediate vaccination is correct, but **rabies immunoglobulin** is not necessary for a minor abrasion without bleeding (Category II exposure). - Administration of RIG is only indicated after **Category III exposures** due to the higher risk of rabies transmission.

Q: STDs are transmitted by

Direct contact. ***Direct contact*** - **Sexually Transmitted Diseases (STDs)** are primarily spread through direct physical contact, most commonly during **sexual activity** (vaginal, anal, or oral sex). - This mode of transmission allows for the exchange of infected bodily fluids or skin-to-skin contact, leading to the spread of pathogens like bacteria, viruses, or parasites. *Contact with soil* - Diseases transmitted through contact with soil, such as **tetanus** or **hookworm infections**, typically involve pathogens that reside in the soil. - This is not a primary mode of transmission for common STDs. *Droplet infection* - **Droplet infection** involves the transmission of pathogens through respiratory droplets expelled during coughing, sneezing, or talking, like in **influenza** or **tuberculosis**. - STDs are generally not aerosolized and do not spread through this route. *Vector borne* - **Vector-borne diseases** are transmitted by an intermediate organism, often an insect (e.g., **mosquitoes** for malaria, **ticks** for Lyme disease). - STDs do not rely on vectors for transmission between human hosts.

Q: Which one of the following mosquitoes is responsible for transmitting Japanese encephalitis?

Culex tritaeniorhynchus. ***Culex tritaeniorhynchus*** - This mosquito species is the **primary vector** for **Japanese encephalitis virus (JEV)** transmission in many endemic regions of Asia. - It typically breeds in **rice paddies** and other agricultural water sources, allowing for efficient transmission within populations. *Aedes aegypti* - This mosquito is the main vector for **Dengue**, **Chikungunya**, and **Zika** viruses. - It is not a significant vector for Japanese encephalitis. *Anopheles stephensi* - This mosquito is a major vector for **malaria**, particularly in urban areas of India. - It primarily transmits **Plasmodium parasites** and is not associated with Japanese encephalitis. *Mansonia* - Mosquitoes of the *Mansonia* genus are known vectors for **lymphatic filariasis** and some arboviruses. - They are not considered primary vectors for Japanese encephalitis.

Q: Which of the following diseases has man as an incidental host with ‘Pig → Mosquito → Pig’ as the basic cycle of transmission?

Japanese encephalitis. ***Japanese encephalitis*** - **Japanese encephalitis** is a viral disease where humans are incidental dead-end hosts. - The established transmission cycle involves **pigs as amplifying hosts** and mosquitoes (primarily *Culex tritaeniorhynchus*) as vectors, which then infect other pigs, maintaining the "Pig → Mosquito → Pig" cycle. - Water birds serve as natural reservoir hosts, while pigs amplify the virus. *Handigodu syndrome* - **Handigodu disease** is another name for **Kyasanur Forest Disease (KFD)** or a related viral hemorrhagic fever from the same region in Karnataka, India. - It is a tick-borne viral disease, not mosquito-borne, with monkeys and small mammals as reservoir hosts. - There is no "Pig → Mosquito → Pig" transmission cycle involved. *Chikungunya* - **Chikungunya** is a viral disease transmitted primarily by *Aedes aegypti* and *Aedes albopictus* mosquitoes, with humans being the primary reservoir hosts. - The transmission cycle is "Human → Mosquito → Human," not involving pigs as amplifying hosts. *Kyasanur forest disease* - **Kyasanur forest disease (KFD)** is a viral hemorrhagic fever transmitted by *Haemaphysalis* ticks, with monkeys and small mammals serving as reservoir hosts. - The transmission cycle involves ticks and forest animals, not pigs and mosquitoes, and humans are incidental hosts.

Q: What is the most important test to assess the prevalence of tuberculosis infection in a community?

Tuberculin test. ***Tuberculin test*** - The **tuberculin skin test (TST)**, or Mantoux test, measures the delayed-type hypersensitivity reaction to tuberculin, indicating prior exposure to *Mycobacterium tuberculosis*. - A positive TST reflects **tuberculosis infection**, whether latent or active, making it a valuable tool for assessing prevalence in a community. *Mass miniature radiography* - This method, now largely replaced by digital radiography, primarily detects **active pulmonary tuberculosis** by identifying lung lesions like infiltrates or cavities. - It is less effective for detecting **latent tuberculosis infection (LTBI)**, which represents the majority of infected individuals in a community. *Sputum examination of AFB* - This test is crucial for diagnosing **active pulmonary tuberculosis** by identifying acid-fast bacilli (AFB) in sputum. - However, it only detects individuals who are actively shedding bacteria and may not capture the broader prevalence of **latent infection** in a community. *Clinical examination* - A clinical examination primarily identifies individuals with **symptoms of active tuberculosis**, such as persistent cough, fever, or weight loss. - It is not a reliable method for assessing the overall **prevalence of tuberculosis infection**, particularly asymptomatic latent cases, in a community.

Q: What is the window period for HIV infection?

6 – 24 weeks. ***6 – 24 weeks*** - The **window period** for HIV infection refers to the time after initial infection during which **antibodies have not yet developed** to a detectable level. - While it can vary depending on the testing method, the **6-24 week range** generally encompasses the period for traditional antibody tests to become positive. - This is the **conservative estimate** used for conventional HIV antibody testing, ensuring adequate time for seroconversion in most individuals. *3 – 6 weeks* - While many individuals will develop detectable antibodies within this timeframe, this range is **too narrow** to capture all cases of seroconversion. - Some individuals may take longer (up to 12 weeks or more) to develop detectable antibody levels, making this an **incomplete window period**. - The 6-24 week range provides a more **conservative and comprehensive** testing window. *3 – 15 days* - This timeframe is typically **too short** for the body to produce a detectable antibody response to HIV. - **Early HIV infection** during this period would likely be detected by more sensitive tests, such as **HIV RNA PCR**, which detect viral genetic material directly. - This represents the **eclipse period** rather than the full antibody window period. *6 – 8 months* - While some individuals may take longer to seroconvert, 6-8 months is generally considered **outside the typical window period** for most conventional HIV antibody tests. - Most people will develop detectable antibodies much earlier than this, usually within **3-12 weeks**. - This timeframe is excessively long and not reflective of standard testing protocols.

Q: With reference to dengue virus, consider the following statements: 1. In India, all the four serotypes are found. 2. The reservoir of infection is both man and mosquito. 3. Adults usually have a milder disease than children. 4. Dengue hemorrhagic fever is caused by infection with more than one dengue virus. Which of the statements given above is/are correct?

1, 2 and 4. ***1, 2 and 4*** - **All four serotypes** (DEN-1, DEN-2, DEN-3, and DEN-4) of the dengue virus are endemic in India, contributing to the recurrent outbreaks seen across the country. - Dengue is a **vector-borne disease**, meaning the virus cycles between humans (the primary reservoir) and mosquitoes (specifically *Aedes aegypti* and *Aedes albopictus*), making both essential for its transmission. - **Dengue hemorrhagic fever (DHF)**, or severe dengue, is often associated with a **second infection by a different serotype** of the dengue virus due to antibody-dependent enhancement (ADE). *2, 3 and 4* - The statement that adults usually have a milder disease than children is **incorrect**; children often present with milder, non-specific symptoms, while adults are more likely to develop typical dengue fever or severe forms. - The other statements regarding the presence of all four serotypes, the reservoir, and the cause of DHF are correct. *4 only* - While statement 4 (DHF caused by infection with more than one serotype) is correct, it overlooks the accuracy of statements 1 and 2. - Omitting statements 1 and 2 makes this option incomplete as both are established facts about dengue. *1 and 2 only* - This option correctly identifies that all four serotypes exist in India and that humans and mosquitoes serve as reservoirs. - However, it **incorrectly excludes statement 4** regarding the etiology of dengue hemorrhagic fever (DHF), which results from sequential infection with a different serotype.

Q: Consider the following vectors: 1. Aedes mosquito 2. Flea 3. Ticks 4. Itchmite Transovarian transmission is demonstrated in

1 and 3. ***1 and 3*** - **Aedes mosquito** (*Aedes aegypti*, *Aedes albopictus*) demonstrates well-established transovarian transmission for multiple arboviruses including **dengue**, **Zika**, **chikungunya**, and **yellow fever**. This mechanism allows the virus to persist in mosquito populations even without vertebrate hosts. - **Ticks** (e.g., *Ixodes*, *Dermacentor*, *Amblyomma* species) are classic examples of transovarian transmission, transmitting pathogens like **Rickettsia** (Rocky Mountain spotted fever, tick typhus), **Babesia**, **Crimean-Congo hemorrhagic fever virus**, and **Kyasanur Forest disease virus**. This is a key epidemiological feature distinguishing tick-borne diseases. *2 and 4* - **Fleas** primarily transmit **plague** (*Yersinia pestis*) horizontally through infected flea bites or contaminated feces. While some rickettsiae (*R. typhi*, *R. felis*) can show limited transovarian transmission in fleas, this is not a prominent or classically emphasized feature compared to mosquitoes and ticks. - **Itchmite** (*Sarcoptes scabiei*) causes **scabies** by direct skin infestation and is not a vector for other pathogens. It does not demonstrate transovarian transmission of disease agents. *1 and 2* - While **Aedes mosquitoes** demonstrate prominent transovarian transmission, **fleas** do not typically exhibit this as a major transmission mode for their primary pathogens. *3 and 4* - **Ticks** exhibit transovarian transmission, but **itchmite** is a direct parasite, not a disease vector with transovarian transmission capability.

Question 1

A person has presented with history of dog-bite on the uncovered surface of his right leg. There is a minor abrasion without bleeding. Consider the following statements about management :

1. The bite should be taken as a category I contact with suspect animal
2. The bite requires local treatment of the wound
3. The person requires immediate vaccination
4. The person requires immediate administration of rabies immunoglobulin Which of the above statements are correct ?

Accepted Answer

2 and 3 only

Answer

1 and 2

Answer

2, 3 and 4

Answer

3 and 4 only

Question 2

STDs are transmitted by

Accepted Answer

Direct contact

Answer

Contact with soil

Answer

Droplet infection

Answer

Vector borne

Question 3

As per ICMR guidelines, which of the following are the criteria for SARS-COV-2 exposure for a pregnant female during the COVID-19 pandemic?

1. Travel to an affected country within previous 14 days
2. Close contact with a confirmed case within a distance of 1 metre for more than 15 minutes
3. Residing in a containment zone
4. Healthcare workers examining a confirmed case without adequate protection

Accepted Answer

1, 2 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 4

Which one of the following mosquitoes is responsible for transmitting Japanese encephalitis?

Accepted Answer

Culex tritaeniorhynchus

Answer

Aedes aegypti

Answer

Anopheles stephensi

Answer

Mansonia

Question 5

Which of the following diseases has man as an incidental host with ‘Pig → Mosquito → Pig’ as the basic cycle of transmission?

Accepted Answer

Japanese encephalitis

Answer

Handigodu syndrome

Answer

Chikungunya

Answer

Kyasanur forest disease

Question 6

What is the most important test to assess the prevalence of tuberculosis infection in a community?

Accepted Answer

Tuberculin test

Answer

Mass miniature radiography

Answer

Sputum examination of AFB

Answer

Clinical examination

Question 7

What is the window period for HIV infection?

Accepted Answer

6 – 24 weeks

Answer

3 – 6 weeks

Answer

3 – 15 days

Answer

6 – 8 months

Question 8

With reference to dengue virus, consider the following statements:

1. In India, all the four serotypes are found.
2. The reservoir of infection is both man and mosquito.
3. Adults usually have a milder disease than children.
4. Dengue hemorrhagic fever is caused by infection with more than one dengue virus. Which of the statements given above is/are correct?

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

4 only

Answer

1 and 2 only

Question 9

Consider the following features of food poisoning:
'Incubation period less than 24 hours, source of infection is milk products, and symptoms include diarrhoea and vomiting.'
To which of the following does the above description apply?

1. Staphylococcal food poisoning
2. Salmonella food poisoning
3. Botulism
Select the correct answer using the code given below:

Accepted Answer

1 only

Answer

2 only

Answer

1 and 3

Answer

1 and 2

Question 10

Consider the following vectors:

1. Aedes mosquito
2. Flea
3. Ticks
4. Itchmite

Transovarian transmission is demonstrated in

Accepted Answer

1 and 3

Answer

2 and 4

Answer

1 and 2

Answer

3 and 4

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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