Infectious Diseases — MCQs

Infectious Diseases Indian Medical PG Practice Questions and MCQs

Question 631: In the context of malaria control, when is regular insecticidal spray recommended based on the Annual Parasite Index (API)?

A. < 1
B. < 2
C. > 2 (Correct Answer)
D. > 1

Explanation: ***> 2*** - Regular insecticidal spray, particularly **Indoor Residual Spraying (IRS)**, is a key malaria control measure recommended when the **Annual Parasite Index (API) is greater than 2**. - An API greater than 2 indicates **high endemicity** with a significant burden of malaria transmission in the community, necessitating aggressive vector control strategies. - According to **NVBDCP (National Vector Borne Disease Control Programme) guidelines**, API > 2 defines high-risk areas where routine IRS is implemented as a core intervention. *> 1* - An API between 1-2 represents **moderate endemicity**, where the focus is primarily on **active case detection, prompt treatment, and targeted interventions** rather than universal spraying. - While vector control remains important, routine widespread IRS is not the standard recommendation at this threshold. *< 2* - An API of less than 2 (which includes both moderate and low endemic areas) does not routinely warrant universal insecticidal spraying programs. - In areas with API < 2, **case management, surveillance, and selective vector control** are prioritized over widespread IRS campaigns. *< 1* - An API of less than 1 indicates **low endemicity**, where malaria transmission is minimal and sporadic. - In such areas, **surveillance, prompt case detection and treatment, and targeted interventions** are the mainstay, with IRS reserved only for focal outbreaks or high-risk pockets.

Question 632: What is the most common mode of transmission of HIV?

A. Occupational exposure (needle stick injury)
B. Perinatal transmission (mother to child)
C. Sexual contact (Correct Answer)
D. Transmission via blood and blood products

Explanation: ***Sexual contact*** - **Unprotected sexual intercourse**, both heterosexual and homosexual, is overwhelmingly the most common way HIV is transmitted globally. - The virus can be exchanged through **bodily fluids** such as semen, vaginal fluids, and rectal fluids during sexual activity. - Accounts for approximately **80% of new HIV infections** worldwide. *Occupational exposure (needle stick injury)* - While a recognised mode of transmission, **needle stick injuries** account for a very small percentage of total HIV infections, primarily affecting healthcare workers. - The risk of transmission per exposure is relatively low (approximately **0.3%**), especially compared to sexual contact. *Perinatal transmission (mother to child)* - **Mother-to-child transmission** can occur during pregnancy, childbirth, or breastfeeding. - Although significant, especially in resource-limited settings, global efforts and **PMTCT programs** have resulted in a significant reduction in this type of transmission. *Transmission via blood and blood products* - This mode was once a major concern but is now extremely rare in countries with robust **blood screening programs**. - While sharing contaminated needles among **intravenous drug users** remains a risk, transfusion-related HIV is largely controlled.

Question 633: Behavioral surveillance survey is done in?

A. AIDS (Correct Answer)
B. TB
C. Filaria
D. Malaria

Explanation: ***AIDS*** - Behavioral surveillance surveys are crucial for understanding and monitoring behaviors related to **HIV transmission**, such as sexual practices and drug use, among at-risk populations. - These surveys help in designing and evaluating **prevention programs** by identifying trends in risky behaviors and knowledge, attitudes, and practices (KAP) concerning HIV. *Filaria* - Surveillance for filaria primarily involves **entomological surveys** (mosquito monitoring) and **parasitological surveys** (blood examinations for microfilariae). - Behavioral aspects are less central to direct surveillance compared to disease vectors and infection rates. *TB* - Tuberculosis surveillance mainly focuses on **case detection**, **treatment outcomes**, and monitoring **drug resistance** through clinical and laboratory data. - While patient adherence to treatment involves behavior, there isn't a dedicated "behavioral surveillance survey" method specifically for TB. *Malaria* - Malaria surveillance involves monitoring **parasitemia rates**, **vector populations**, and **antimalarial drug resistance**. - Behavioral components like bed net usage are important, but the primary surveillance methods are not termed "behavioral surveillance surveys" in the same structured way as for HIV.

Question 634: What is a major sign for AIDS surveillance in the WHO case definition?

A. Weight loss greater than 10% (Correct Answer)
B. Chronic cough for more than 1 month
C. Generalized lymphadenopathy
D. Disseminated herpes infection

Explanation: ***Weight loss greater than 10%*** - **Weight loss >10% of body weight** is one of the **three major signs** in the WHO clinical case definition for AIDS surveillance. - The **three major signs** are: (1) Weight loss >10%, (2) Chronic diarrhea >1 month, and (3) Prolonged fever >1 month. - This symptom reflects **"wasting syndrome,"** a severe manifestation of advanced HIV disease indicating significant metabolic and immunological dysfunction. - Major signs are critical for AIDS surveillance, especially in resource-limited settings where laboratory diagnosis may not be readily available. *Chronic cough for more than 1 month* - This is classified as a **minor sign**, not a major sign, in the WHO AIDS surveillance definition. - While chronic cough can indicate opportunistic infections like tuberculosis or *Pneumocystis jirovecii* pneumonia in HIV-infected individuals, it does not meet the criteria for a major sign. - WHO clinical staging requires major signs to have greater specificity for advanced disease. *Generalized lymphadenopathy* - **Generalized lymphadenopathy** is a **minor sign** in the WHO case definition. - Also known as Persistent Generalized Lymphadenopathy (PGL), it is common in early to chronic HIV infection but does not typically signify AIDS-stage disease. - It involves lymph node enlargement in two or more non-contiguous sites (excluding inguinal nodes) for more than 3 months. *Disseminated herpes infection* - Chronic progressive or disseminated herpes simplex infection is classified as a **minor sign**, not a major sign. - While severe herpes infections (including recurrent herpes zoster) are associated with immunosuppression in HIV, they are part of the minor criteria in WHO AIDS surveillance. - Major signs are reserved for more specific indicators of severe immunodeficiency and wasting.

Question 635: The international quarantine period for yellow fever as approved by the Government of India is ?

A. 6 days (Correct Answer)
B. 9 days
C. 10 days
D. 12 days

Explanation: ***6 days*** - The **incubation period** for yellow fever is typically 3-6 days, and the 6-day quarantine period is internationally accepted to cover this range. - This period is established to prevent the importation and spread of the disease by ensuring that individuals arriving from endemic areas do not develop symptoms after arrival. *9 days* - This duration is **longer than the internationally recognized incubation period** for yellow fever and is not the standard quarantine period. - Implementing a 9-day quarantine would be excessive and not based on the typical disease progression. *10 days* - A 10-day quarantine period is also **not the standard** for yellow fever as approved by international health regulations or by the Government of India. - While some diseases may require a 10-day quarantine, yellow fever's incubation period makes 6 days sufficient. *12 days* - A 12-day quarantine is **significantly longer** than necessary for yellow fever, as virtually all cases would manifest symptoms within the first 6 days. - This period is typically associated with diseases with much longer incubation periods, which is not the case for yellow fever.

Question 636: In which condition is a night blood survey performed?

A. Lymphatic filariasis (Correct Answer)
B. Typhoid fever
C. Malaria infection
D. Visceral leishmaniasis

Explanation: ***Lymphatic filariasis*** - A **night blood survey** is crucial for diagnosing lymphatic filariasis because the microfilariae of species like *Wuchereria bancrofti* and *Brugia malayi* exhibit **nocturnal periodicity**, meaning they are most abundant in peripheral blood between 10 PM and 2 AM. - Collecting blood at night maximizes the chance of detecting these parasites, which are responsible for the disease. *Typhoid fever* - Diagnosis of **typhoid fever** primarily relies on **blood cultures** taken during the febrile phase, or stool/urine cultures later in the disease. - A night blood survey is not relevant for detecting the causative bacterium, *Salmonella Typhi*. *Malaria infection* - While a **blood smear** is essential for diagnosing malaria, the timing of blood collection is less critical than for filariasis, although peak parasite density can vary. - **Malaria parasites** are typically detected in blood samples taken during symptomatic periods, regardless of specific time of day. *Visceral leishmaniasis* - **Visceral leishmaniasis** is diagnosed by detecting parasites in samples from **bone marrow**, spleen, or lymph nodes, or through serological tests for antibodies. - A night blood survey is not used in the diagnosis of *Leishmania donovani* infection.

Question 637: Malaria is transmitted in Rural areas by?

A. Anopheles stephensi
B. Anopheles dirus
C. Anopheles culicifacies (Correct Answer)
D. None of the options

Explanation: ***Anopheles culicifacies*** - **_Anopheles culicifacies_** is the **primary vector of malaria in rural areas of India** and is also found in Southeast Asia. - Its breeding habitats often include **rice fields, irrigation channels, and temporary water collections** common in rural agricultural settings. - It accounts for a major proportion of rural malaria transmission in the Indian subcontinent. *Anopheles stephensi* - **_Anopheles stephensi_** is a significant malaria vector primarily found in **urban and semi-urban areas**, including parts of the Middle East, India, and Iran. - Its preferred breeding sites are **artificial containers found in urban environments**, such as water storage tanks, overhead tanks, and cisterns. *Anopheles dirus* - **_Anopheles dirus_** is a dominant malaria vector in **forested and hilly regions of Southeast Asia**, often associated with forest malaria. - It's known for outdoor feeding behavior and maintaining transmission in relatively undisturbed natural environments. *None of the options* - This option is incorrect because **_Anopheles culicifacies_** is a well-established and significant vector for malaria in rural areas of India. - Identification of a specific primary vector for rural transmission makes this choice invalid.

Question 638: Most effective preventive measure against rabies

A. Heat
B. Humidity
C. Avoiding contact with infected animals and vaccination (Correct Answer)
D. None of the options

Explanation: ***Avoiding contact with infected animals and vaccination*** ✓ - The most effective preventive measure against rabies is to **avoid contact with potentially infected animals**, especially wild animals and unvaccinated domestic animals. - **Vaccination** (pre-exposure prophylaxis) is crucial for individuals at high risk of exposure (veterinarians, animal handlers, laboratory workers) and for domestic animals, forming the cornerstone of rabies prevention. - Post-exposure prophylaxis (PEP) with immunoglobulin and vaccine series is highly effective when administered promptly after exposure. *Heat* - While high temperatures can inactivate the rabies virus in a laboratory setting, it is **not a practical or effective preventive measure** against rabies in real-world scenarios. - The virus is transmitted through bites, scratches, and mucous membrane contact with infected saliva; environmental heat does not prevent transmission or infection. *Humidity* - **Humidity does not play a significant role** in the prevention or transmission of rabies. - The rabies virus is labile outside of a host and does not survive long in the environment, regardless of humidity levels. *None of the options* - This option is incorrect because there are highly effective preventive measures against rabies, as detailed in the correct option. - Rabies prevention is well-established through public health interventions (animal vaccination programs, post-exposure prophylaxis) and individual precautions.

Question 639: Which of the following diseases is NOT transmitted by sandflies?

A. Visceral Leishmaniasis
B. Oriental sore
C. Relapsing fever (Correct Answer)
D. Cutaneous Leishmaniasis

Explanation: ***Relapsing fever*** - **Relapsing fever** is primarily transmitted by **ticks** (tick-borne relapsing fever) or **lice** (louse-borne relapsing fever), not sandflies. - It is caused by **spirochetes** of the genus *Borrelia*, which are distinct from the *Leishmania* parasites transmitted by sandflies. *Cutaneous Leishmaniasis* - **Cutaneous leishmaniasis** is a **sandfly-borne disease** caused by *Leishmania* parasites, leading to skin sores. - Sandflies (genus **Phlebotomus** in the Old World and **Lutzomyia** in the New World) transmit these parasites. *Visceral Leishmaniasis* - **Visceral leishmaniasis**, also known as **kala-azar**, is a severe form of leishmaniasis transmitted by the bite of **infected female sandflies**. - It affects internal organs like the **spleen**, **liver**, and **bone marrow**. *Oriental sore* - **Oriental sore** is another name for **cutaneous leishmaniasis**, indicating that it is also transmitted by **sandflies**. - It refers to the characteristic **skin lesions** caused by *Leishmania* parasites following a sandfly bite.

Question 640: Which of the following diseases is classified under category-B of bioterrorism?

A. Anthrax
B. Plague
C. Botulism
D. Cholera (Correct Answer)

Explanation: ***Cholera*** - **Cholera** is classified under **Category B** agents due to its moderate ease of dissemination, moderate morbidity rates, and low mortality rates. - While it can cause severe diarrheal disease, its treatment is relatively straightforward with **rehydration therapy**, and it poses a lower risk of mass casualties compared to Category A agents. *Anthrax* - **Anthrax** is a **Category A** bioterrorism agent, characterized by its high mortality rate, ease of dissemination, and potential for major public health impact. - It poses a significant threat due to its ability to form **spores** that are highly resistant and can cause severe lung infection. *Plague* - **Plague** is designated as a **Category A** agent because of its high potential for mass dissemination, high mortality if untreated, and potential to cause widespread panic. - It can be spread via **aerosols** and can lead to severe systemic illness. *Botulism* - **Botulism** is classified as a **Category A** agent due to the extreme potency of the **botulinum toxin**, even in minute quantities, which can cause severe flaccid paralysis and death. - It has a high potential for causing severe public health impact and requires complex medical interventions.

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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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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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