Infectious Diseases — MCQs

Infectious Diseases Indian Medical PG Practice Questions and MCQs

Question 641: 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 642: Based on the type of life cycle, zoonoses are classified into all of the following except -

A. Cyclo-zoonoses
B. Anthropozoonoses (Correct Answer)
C. Sporozoonoses
D. Meta-zoonoses

Explanation: ***Anthropozoonoses*** - This is **NOT a life cycle-based classification** of zoonoses. - It describes the **direction of transmission** (animals to humans), not the complexity or types of hosts required in the parasite's life cycle. - While a valid classification of zoonoses, it is based on **transmission pattern**, not life cycle characteristics. *Cyclo-zoonoses* - These are zoonoses that require **more than one vertebrate host species** to complete their life cycle, but **no invertebrate host** is involved. - This IS a life cycle-based classification. - Examples include **taeniasis** (tapeworm infections) where the parasite cycles between humans and livestock. *Meta-zoonoses* - These zoonoses require **both vertebrate and invertebrate hosts** to complete their life cycle. - This IS a life cycle-based classification. - The **invertebrate host** acts as an essential part of the life cycle for maturation or multiplication of the pathogen (e.g., **arboviruses** transmitted by mosquitoes, **plague** via fleas). *Sporozoonoses* - While this term is **not part of the standard WHO classification** of zoonoses by life cycle, the prefix "sporo-" refers to **spore-forming stages** in parasitic life cycles. - The standard WHO classification includes: **Orthozoonoses** (direct), **Cyclozoonoses**, **Metazoonoses**, and **Saprozoonoses** (requiring inanimate environment). - However, this term relates to life cycle characteristics (spore stages), not transmission direction.

Question 643: 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 644: 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.

Question 645: 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 646: Infectivity period of chickenpox is ?

A. 1 day before and 4 days after appearance of rash (Correct Answer)
B. Only when scab falls
C. Entire incubation period
D. 4 days before and 5 days after appearance of rash

Explanation: ***1 day before and 4 days after appearance of rash*** - The infectivity period of **chickenpox (varicella)** begins approximately **1-2 days (24-48 hours) before the rash appears**. - It extends until **all lesions have crusted over**, which typically occurs around **5-6 days after rash onset**, though some sources cite **4-5 days**. - This option represents the **commonly accepted timeframe** taught in Indian medical curricula and NEET PG examinations. *4 days before and 5 days after appearance of rash* - The **pre-rash infectivity period is too long** in this option; chickenpox is infectious for only **1-2 days before rash**, not 4 days. - While the "5 days after" is medically accurate, the incorrect pre-rash duration makes this option wrong. *Only when scab falls* - This statement is **incorrect**; infectivity starts much earlier, **1-2 days before the rash appears**. - By the time scabs fall, the person is **no longer infectious**, as crusted lesions contain non-infectious material. - This option ignores the critical **pre-rash and early rash infectious period**. *Entire incubation period* - The **incubation period** for chickenpox is usually **10-21 days**, during which the individual is **not infectious** for most of this time. - Infectivity begins only in the **last 1-2 days of incubation** (just before rash onset) and continues into the eruptive phase, not for the entire duration.

Question 647: What is the recommended concentration of diethylcarbamazine in DEC medicated salt for the treatment of endemic filariasis?

A. 5-10 gm/kg
B. 0.1-0.2 gm/kg (Correct Answer)
C. 0.5-1.0 gm/kg
D. 2-4 gm/kg

Explanation: ***0.1-0.2 gm/kg*** - The recommended concentration of **diethylcarbamazine (DEC)** in medicated salt for the treatment of endemic filariasis is typically 0.1-0.2 gm/kg of salt. - This low, sustained dose helps to gradually eliminate microfilariae and prevent transmission without causing severe adverse reactions. *0.5-1.0 gm/kg* - This concentration is significantly higher than the standard recommendation for mass drug administration using DEC medicated salt. - Such a higher dose would increase the risk of adverse drug reactions, making it unsuitable for community-wide use. *2-4 gm/kg* - This concentration is far too high for safe and effective use in DEC medicated salt programs. - Administering DEC at this level would likely lead to widespread and potentially severe side effects among the treated population. *5-10 gm/kg* - Concentrations in this range are excessively high and would be toxic if used in medicated salt for filariasis treatment. - This would result in widespread and severe adverse events, making it an unacceptable option.

Question 648: What is the date observed as World AIDS Day?

A. 7 April
B. 3 May
C. 5 June
D. 1 December (Correct Answer)

Explanation: ***Correct Answer: 1 December*** - **World AIDS Day** is observed annually on **December 1st** to raise awareness about the AIDS pandemic caused by the spread of **HIV infection** and to mourn those who have died of the disease. - This date was chosen by James W. Bunn and Thomas Netter, two public information officers for the Global Programme on AIDS at the **World Health Organization (WHO)**, in August 1987. - The first World AIDS Day was observed in **1988**. *Incorrect: 7 April* - **April 7th** is recognized as **World Health Day**, which marks the anniversary of the founding of the World Health Organization (WHO) in 1948. - This day focuses on a specific health theme each year to highlight a priority area of concern for the WHO. *Incorrect: 3 May* - **May 3rd** is celebrated as **World Press Freedom Day**, which aims to raise awareness of the importance of freedom of the press and to remind governments of their duty to respect and uphold the right to freedom of expression. - This date does not have a direct association with AIDS awareness or public health campaigns. *Incorrect: 5 June* - **June 5th** is designated as **World Environment Day**, the United Nations' principal vehicle for encouraging worldwide awareness and action for the protection of our environment. - This day is focused on environmental issues and sustainability, not specifically on HIV/AIDS.

Question 649: Which indicator best measures the operational efficiency of a malaria control programme?

A. Infant parasite rate
B. Slide positivity rate
C. Mosquito bite rate
D. Annual blood examination rate (Correct Answer)

Explanation: ***Annual blood examination rate*** - The **Annual Blood Examination Rate (ABER)** directly reflects the proportion of the population that has been tested for malaria, indicating the reach and effectiveness of surveillance activities. - A high ABER suggests that active case detection and diagnosis are being effectively implemented, which is crucial for operational efficiency in identifying and managing cases. *Infant parasite rate* - The **infant parasite rate** measures the prevalence of malaria infection among infants, serving as an indicator of recent transmission intensity. - While important for assessing disease burden and transmission, it doesn't directly measure the operational effectiveness of interventions like testing or treatment programs. *Slide positivity rate* - The **slide positivity rate (SPR)** is the proportion of positive malaria slides among all slides examined, indicating the likelihood of an individual seeking testing to actually have malaria. - While SPR helps understand disease activity among tested individuals, it doesn't reflect the full operational reach of a program in the general population or the overall testing effort. *Mosquito bite rate* - The **mosquito bite rate** measures the number of mosquito bites per person per night, indicating the level of human exposure to malaria vectors. - This is an entomological indicator of transmission risk and the impact of vector control, but it does not directly assess the operational efficiency of human-centric interventions like diagnosis and treatment programs.

Question 650: 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.

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