Infectious Diseases — MCQs

Infectious Diseases Indian Medical PG Practice Questions and MCQs

Question 611: Contact isolation is done for

A. Mumps
B. Asthma
C. Diphtheria
D. MRSA (Correct Answer)

Explanation: ***MRSA*** - **Methicillin-resistant *Staphylococcus aureus* (MRSA)** is transmitted primarily through direct contact with infected patients or contaminated surfaces, necessitating **contact isolation**. - **Contact precautions** involve the use of **gloves** and **gowns** when entering the patient's room to prevent transmission. *Mumps* - Mumps is a viral infection that is primarily transmitted via **respiratory droplets** produced during coughing, sneezing, or talking. - Patients with mumps typically require **droplet isolation**, not contact isolation, to prevent airborne transmission. *Diphtheria* - Diphtheria is a bacterial infection spread through **respiratory droplets** from the nose and throat of an infected person. - **Droplet precautions** are generally recommended for diphtheria, involving masks within a certain distance, rather than contact isolation. *Asthma* - **Asthma** is a chronic inflammatory condition of the airways and is not an infectious disease. - As asthma is not transmissible, it does **not require any form of isolation precautions** (contact, droplet, or airborne).

Question 612: Which software is specifically designed for monitoring the tuberculosis control programme under the National Tuberculosis Elimination Programme (NTEP), formerly RNTCP, in India?

A. NICHAY
B. NIKSHAY (Correct Answer)
C. E-DOTS
D. NIRBHAI

Explanation: ***NIKSHAY*** - **NIKSHAY** is the dedicated web-based solution for managing the **National Tuberculosis Elimination Programme (NTEP)** in India. - It is used for comprehensive TB patient management, from registration and treatment monitoring to drug stock management and outcome recording. *NICHAY* - "NICHAY" is a misspelling and does not refer to any official software or program associated with TB control in India. - This option is intended as a plausible-sounding distractor based on the correct answer. *E-DOTS* - **DOTS (Directly Observed Treatment, Short-course)** is a strategy for TB treatment delivery, not a specific software platform in India. - While electronic systems are used for DOTS, "E-DOTS" is a general term and not the official name of the NTEP monitoring software. *NIRBHAI* - "NIRBHAI" is not related to any official software or initiative for tuberculosis control under the NTEP in India. - This is a distractor and does not correspond to any known medical or public health program.

Question 613: Which of the following screening methods is primarily used under the National Tuberculosis Elimination Program (NTEP)?

A. Active
B. Passive (Correct Answer)
C. Mass
D. None of the options

Explanation: ***Passive*** - Under the NTEP, **passive screening** involves individuals presenting to health facilities with symptoms suggestive of TB. - This method relies on **patient self-reporting** and healthcare provider suspicion, rather than active outreach. - Passive case finding is the **primary screening strategy** used across the general population in the NTEP framework. *Active* - **Active screening** involves community-based interventions to proactively identify individuals with TB, often in high-risk populations. - While active case finding is crucial for specific vulnerable groups (contacts, HIV patients, etc.), it is **not the primary screening method** under the standard NTEP framework for initial detection across the entire population. *Mass* - **Mass screening** involves testing large numbers of people in the general population, regardless of symptoms, to detect disease. - This is generally **cost-prohibitive** and not routinely implemented as a primary screening strategy for TB by the NTEP due to resource limitations and low yield in the general population. *None of the options* - **Passive screening** is indeed a primary method used under the NTEP, making this option incorrect. - The NTEP heavily relies on individuals seeking care when they experience symptoms, which aligns with the definition of passive case finding.

Question 614: Which of the following statements about pathogenic mosquitoes is correct?

A. Mansonia mosquitoes lay their eggs in rafts.
B. Culex mosquitoes are primarily vectors for West Nile virus.
C. Aedes mosquitoes are known for their distinctive black and white striped markings.
D. Anopheles mosquitoes are known for transmitting malaria. (Correct Answer)

Explanation: ***Correct: Anopheles mosquitoes are known for transmitting malaria.*** - **Anopheles mosquitoes** are the **primary and only vectors** for **malaria**, a parasitic disease caused by Plasmodium parasites. - They transmit the parasite through their **saliva** when they bite humans, typically during **dusk and dawn**. - This is the most significant pathogenic association among the options. *Incorrect: Mansonia mosquitoes lay their eggs in rafts.* - **Mansonia mosquitoes** lay their eggs in **clusters attached to underwater parts of aquatic plants**, not in rafts. - **Culex mosquitoes** are the ones that lay their eggs in **raft-like formations** on water surfaces. *Incorrect: Culex mosquitoes are primarily vectors for West Nile virus.* - While **Culex mosquitoes** can transmit West Nile virus, in the **Indian context** they are primarily known as vectors for **lymphatic filariasis** (Wuchereria bancrofti) and **Japanese encephalitis**. - West Nile virus is more relevant in Western countries and is not the primary disease association for Culex in India. *Incorrect: Aedes mosquitoes are known for their distinctive black and white striped markings.* - While **Aedes aegypti** and **Aedes albopictus** do have **black and white striped markings**, this is a **morphological characteristic** rather than a primary **pathogenic association**. - The question asks about pathogenic mosquitoes, and Aedes is better characterized by its **disease transmission** (dengue, Zika, chikungunya, yellow fever) rather than its appearance. - As a pathogenic mosquito, its **daytime biting behavior** and **urban breeding habits** are more relevant than its markings.

Question 615: Drug of choice for mass therapy under filariasis control programme?

A. Albendazole
B. Ivermectin
C. DEC (Correct Answer)
D. Mebendazole

Explanation: ***Correct: DEC*** - **Diethylcarbamazine (DEC)** is the drug of choice for **mass drug administration (MDA)** campaigns aimed at eliminating lymphatic filariasis. - It effectively kills **microfilariae** and has some action on adult worms, reducing transmission. - In India's National Filariasis Elimination Programme, DEC is administered along with Albendazole in annual MDA campaigns. *Incorrect: Albendazole* - While **Albendazole** is co-administered with DEC in MDA programs, it is not the sole drug of choice for mass treatment of filariasis. - Its primary role is to provide **macrofilaricidal** activity (killing adult worms) and co-treatment for other helminth infections. - It enhances the effect of DEC but is not used alone. *Incorrect: Ivermectin* - **Ivermectin** is used in MDA programs for filariasis, particularly in areas co-endemic with **onchocerciasis** or where **Loa loa** is prevalent (as DEC is contraindicated in these areas). - However, in India and most lymphatic filariasis endemic areas, **DEC** remains the primary drug. *Incorrect: Mebendazole* - **Mebendazole** is an anthelminthic primarily used for treating **intestinal nematode infections** like ascariasis, trichuriasis, and hookworm. - It is **not used** in lymphatic filariasis mass treatment programs.

Question 616: Which of the following statements is incorrect regarding the strategic plan for malaria control 2012-2017?

A. 50% reduction in mortality by 2017
B. Objective is API < 1 per 10,000 (Correct Answer)
C. Complete treatment to 100% of patients
D. Annual incidence < 1 per 1000 by 2017

Explanation: ***Objective is API < 1 per 10,000*** - The correct objective for the **Annual Parasite Incidence (API)** in the 2012-2017 strategic plan for malaria control was to reduce it to **less than 1 per 1,000 population**, not 1 per 10,000, making this statement incorrect. - This metric measures the number of new malaria cases per 1,000 people per year. *50% reduction in mortality by 2017* - A key objective of the **National Framework for Malaria Elimination in India** (which this strategic plan aimed to contribute to) was indeed to achieve a significant reduction in malaria-related mortality. - Specifically, aiming for a **50% reduction in mortality** by 2017 was a stated goal to lessen the disease burden. *Annual incidence < 1 per 1000 by 2017* - One of the primary goals of the **Malaria Control Strategic Plan 2012-2017** was to reduce the annual parasite incidence (API) to **less than 1 per 1,000 population** in all endemic areas. - This target focused on decreasing the occurrence of new malaria cases. *Complete treatment to 100% of patients* - A core component of malaria control strategies emphasizes ensuring that **all confirmed malaria cases** receive complete and effective treatment. - Achieving **100% complete treatment adherence** is crucial to prevent drug resistance and eliminate the parasite reservoir.

Question 617: Human, animal, fomite or objects from which infective organism enters the host is called?

A. Infective Reservoir
B. Infective Carrier
C. None of the above
D. Source of infection (Correct Answer)

Explanation: ***Source of infection*** - The **source of infection** refers to the person, animal, object, or substance from which an infectious agent passes immediately to a host. - This can include humans, animals, fomites, or contaminated objects that directly transmit the infectious organism. - This is the proximate source from which the agent enters the host. *Infective Reservoir* - An **infective reservoir** is the long-term habitat where an infectious agent normally lives, grows, and multiplies. - The reservoir can be human, animal, plant, soil, or inanimate matter where the agent is normally found. - While a reservoir can be a source, the source is specifically the immediate point from which transmission occurs. *Infective Carrier* - An **infective carrier** is an infected person or animal that harbors a specific infectious agent without showing clinical symptoms but can transmit it to others. - A carrier is a type of source (when transmission occurs from them), but the term "source" is broader, encompassing inanimate objects and fomites as well. *None of the above* - This option is incorrect because **Source of infection** accurately describes the concept presented in the question.

Question 618: Most common route of nosocomial infection [Hospital-acquired infection]?

A. Droplet transmission
B. Direct contact (Correct Answer)
C. Indirect contact
D. Vehicle transmission

Explanation: **Direct contact** - **Direct contact** with colonized or infected patients is the predominant mode of transmission for many common nosocomial pathogens like **MRSA** and **VRE**. - This often involves healthcare workers' hands becoming contaminated and then touching other patients. *Droplet transmission* - Involves the transmission of infectious agents through **respiratory droplets** produced during coughing, sneezing, or talking. - While significant for some infections (e.g., influenza, pertussis), it is not the most common route overall for nosocomial infections. *Indirect contact* - Occurs when an infectious agent is transferred via a **contaminated intermediate object** or person. - Although important (e.g., contaminated medical devices), it is generally less frequent than direct patient-to-patient transmission. *Vehicle transmission* - Involves transmission through **contaminated inanimate vehicles** like food, water, medications, or surgical instruments. - While outbreaks can occur via this route (e.g., contaminated endoscopes), it is not the most common day-to-day transmission mechanism in hospitals.

Question 619: Which of the following statements about universal precautions is false?

A. Includes use of hand washing
B. Consider that all body fluids are contaminated with blood (Correct Answer)
C. Includes use of gloves and masks
D. To prevent transmission of blood borne pathogens

Explanation: ***Correct: Consider that all body fluids are contaminated with blood*** - This statement is **FALSE** and therefore the correct answer to this question asking what is false about universal precautions. - **Universal precautions** do NOT assume all body fluids are "contaminated with blood." Instead, they specify that **certain body fluids** (blood, semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, amniotic fluid, and any body fluid visibly contaminated with blood) should be treated as **potentially infectious for bloodborne pathogens** (HIV, HBV, HCV). - The distinction is important: it's about **potential infectivity for bloodborne pathogens**, not that all body fluids are literally contaminated with blood. Universal precautions do NOT apply to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomitus unless they contain visible blood. *Incorrect: Includes use of hand washing* - This statement is **TRUE** about universal precautions (therefore incorrect as an answer to what is false). - **Hand hygiene** is a **fundamental component** of universal and standard precautions, essential for preventing transmission of microorganisms between patients and healthcare workers. *Incorrect: Includes use of gloves and masks* - This statement is **TRUE** about universal precautions (therefore incorrect as an answer to what is false). - **Personal protective equipment (PPE)** including gloves, masks, gowns, and eye protection are **integral to universal precautions**. - Gloves are used when contact with blood or specified body fluids is anticipated; masks and eye protection are used during procedures likely to generate splashes or sprays. *Incorrect: To prevent transmission of blood borne pathogens* - This statement is **TRUE** about universal precautions (therefore incorrect as an answer to what is false). - The **primary goal** of universal precautions is to **prevent transmission of bloodborne pathogens** such as HIV, Hepatitis B (HBV), and Hepatitis C (HCV) by creating barriers between healthcare workers and potentially infectious materials.

Question 620: Which of the following is an example of indirect transmission by a living vector?

A. Transmission by mosquito (Correct Answer)
B. Vertical transmission
C. Soil contact
D. Droplet infection

Explanation: ***Transmission by mosquito*** - This is the classic example of **vector-borne transmission**, where a living biological vector (the mosquito) acts as an intermediary to transmit the infectious agent from an infected host to a susceptible one. - The disease-causing microorganism does not pass directly from person to person but is carried and transmitted by the living vector. - Examples include malaria, dengue, and filariasis. *Vertical transmission* - This refers to transmission of disease from a **mother to her child** during pregnancy, childbirth, or breastfeeding. - This is a form of **direct transmission** where the pathogen passes directly between biologically related individuals without an intermediate living vector. *Soil contact* - This represents **vehicle-borne transmission** where soil acts as a non-living vehicle (fomite) carrying pathogens. - While this is technically indirect transmission, it does not involve a **living biological vector** as specified in the question. - Examples include tetanus, hookworm, and ascariasis transmitted through contaminated soil. *Droplet infection* - This is a form of **direct transmission** where infectious droplets are expelled from the respiratory tract of an infected person and directly contact the mucous membranes of a susceptible person. - The droplets travel a short distance in close proximity, representing direct person-to-person transfer without any intermediate vector.

Practice by Chapter

Communicable Disease Control Principles

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Vector-Borne Diseases

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Water-Borne Diseases

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Air-Borne Diseases

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Zoonotic Diseases

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Sexually Transmitted Infections

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HIV/AIDS Control Program

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Tuberculosis Control

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Leprosy Elimination

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Emerging and Re-emerging Infections

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Hospital-Acquired Infections

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Integrated Disease Surveillance Project

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