Infectious Diseases — MCQs
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Malaria is transmitted in Rural areas by?
All of the following are anthropozoonosis except
All following are at-risk group adults meriting Hepatitis B vaccination in low endemic areas except for which of the following?
What is the Chandler's Index for Hookworm that indicates a significant health problem?
What is the recommended amount of bleaching powder necessary to disinfect stools contaminated with cholera?
National Leprosy Eradication Programme was started in -
Schistosomiasis is transmitted by?
Schistosomiasis is an example of which type of zoonosis that requires an intermediate host?
Which of the following diseases does not have a chronic carrier state?
Vector of scrub typhus in man?
Infectious Diseases Indian Medical PG Practice Questions and MCQs
Question 651: 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 652: All of the following are anthropozoonosis except
- A. Rabies
- B. Plague
- C. Anthrax
- D. Schistosomiasis (Correct Answer)
Explanation: ***Schistosomiasis*** - This is a **human-to-human** disease, even though it involves an intermediate **snail host**. - Its life cycle does not involve transmission of pathogens from vertebrate animals to humans. *Rabies* - Rabies is a classic **anthropozoonosis**, transmitted to humans primarily through the saliva of infected animals, most commonly **dogs** and **bats**. - It involves a pathogen (rabies virus) that cycles between animals and can be transmitted to humans. *Plague* - Plague is an **anthropozoonosis** caused by *Yersinia pestis*, typically transmitted from **rodents** (e.g., rats) to humans via flea bites. - The disease maintains a natural reservoir in wild rodent populations, making it a prime example of animal-to-human transmission. *Anthrax* - Anthrax is an **anthropozoonosis** caused by *Bacillus anthracis*, transmitted to humans from infected **livestock** (e.g., cattle, sheep). - Humans usually acquire the infection through contact with infected animals or their products, or by inhaling spores.
Question 653: All following are at-risk group adults meriting Hepatitis B vaccination in low endemic areas except for which of the following?
- A. Medical/nursing personnel
- B. Patients with chronic liver disease
- C. Diabetics on insulin (Correct Answer)
- D. Patients on chronic hemodialysis
Explanation: ***Diabetics on insulin*** - This is the correct answer as the exception based on **guidelines at the time of this exam (2012)**. - At that time, diabetics were **not routinely listed** as a standard at-risk group for hepatitis B vaccination in low endemic areas, though the ACIP was beginning to recognize increased risk in this population. - **Current Update (Post-2012):** The **CDC/ACIP now recommends** hepatitis B vaccination for all previously unvaccinated adults with diabetes aged 19-59 years, due to documented increased risk of HBV infection associated with: - Shared blood glucose monitoring devices - Assisted blood glucose monitoring in healthcare settings - Outbreak investigations showing higher transmission rates - For the purpose of this historical exam question, diabetics were the exception among the listed groups. *Medical/nursing personnel* - Healthcare workers are at **high occupational risk** due to frequent exposure to blood and body fluids. - This has been a **standard, long-standing recommendation** for HBV vaccination regardless of endemic status. - The risk remains present even in low endemic areas due to potential exposure to infected patients. *Patients with chronic liver disease* - Individuals with pre-existing chronic liver disease are at risk of **severe outcomes** if they acquire hepatitis B infection. - Superimposed acute HBV infection can lead to: - Rapid progression to cirrhosis - Acute-on-chronic liver failure - Hepatocellular carcinoma - Vaccination is **crucial for prevention** and has been a standard recommendation. *Patients on chronic hemodialysis* - Hemodialysis patients face **elevated risk** of HBV acquisition due to: - Frequent vascular access procedures - Prolonged time in healthcare settings - Potential for nosocomial transmission in dialysis units - Their **immunocompromised state** increases risk of chronic infection and complications. - Vaccination is a **standard preventive measure** in this population.
Question 654: What is the Chandler's Index for Hookworm that indicates a significant health problem?
- A. > 200
- B. > 100
- C. > 300
- D. > 50 (Correct Answer)
Explanation: ***> 50*** - A Chandler's Index of **> 50** indicates a significant public health problem due to **hookworm infection**. - **Chandler's Index** is calculated as the **average egg count per person in a community** (total hookworm eggs counted ÷ number of persons examined), used to assess the population-level burden of hookworm infection. - A value **> 50** suggests that the community has a significant hookworm problem requiring public health intervention. *> 300* - This value is significantly higher than the threshold for a significant public health problem and would indicate an **extremely severe burden of infection**. - While this represents a very high Chandler's Index, it's not the standard cut-off for defining a "significant" health problem (which is the lower threshold of >50). *> 200* - A Chandler's Index of **> 200** would denote a very high intensity of hookworm infection in the community. - However, this is not the standard threshold used to define when hookworm becomes a "significant" public health issue - the threshold is lower at >50. *> 100* - A Chandler's Index of **> 100** represents a substantial level of hookworm infection within a population. - However, the widely recognized cutoff for a "significant health problem" is **> 50**, indicating public health concern even at this moderate level of community infection burden.
Question 655: What is the recommended amount of bleaching powder necessary to disinfect stools contaminated with cholera?
- A. 50 gm/liter (Correct Answer)
- B. 75 gm/liter
- C. 90 gm/liter
- D. 100 gm/liter
Explanation: ***50 gm/liter*** - For effective disinfection of stools contaminated with cholera, a concentration of **50 gm of bleaching powder per liter** of stool is recommended to ensure the destruction of **Vibrio cholerae**. - This concentration typically provides a sufficient amount of available **chlorine** to inactivate the bacteria within a reasonable contact time. *75 gm/liter* - While this concentration would certainly disinfect, it is **higher than necessary** for routine cholera stool disinfection and leads to inefficient resource use. - Using excess bleaching powder can also create a **stronger odor** and possibly increase the risk of skin or respiratory irritation. *90 gm/liter* - This concentration is **excessive** and not the standard recommendation for cholera stool disinfection. - Higher concentrations contribute to **waste of resources** and do not offer significantly improved efficacy over the recommended dose for this specific application. *100 gm/liter* - This concentration is significantly **higher than required** for effective disinfection of cholera-contaminated stools. - Using such a high amount is **economically inefficient** and offers no additional benefit in terms of disinfection for this specific pathogen and application.
Question 656: National Leprosy Eradication Programme was started in -
- A. 1949
- B. 1955
- C. 1973
- D. 1983 (Correct Answer)
Explanation: **Correct: 1983** - The **National Leprosy Eradication Programme (NLEP)** was launched in India in **1983** - Its goal was to eliminate leprosy as a public health problem by reducing its prevalence rate to less than 1 case per 10,000 population - This marked the shift from control to eradication strategy with the introduction of **Multi-Drug Therapy (MDT)** *Incorrect: 1949* - This year is not associated with the inception of a national leprosy eradication program in India - While efforts against leprosy existed, a comprehensive national program was not established at this time *Incorrect: 1955* - The **National Leprosy Control Programme (NLCP)** was launched in India in **1955** - This was a control program, preceding the eradication program, focusing on diagnosis and treatment with Dapsone monotherapy - NLCP was later upgraded to NLEP in 1983 *Incorrect: 1973* - This year is not cited as the start date for the national leprosy eradication program in India - The focus shifted from control to eradication in 1983 with the adoption of WHO-recommended MDT
Question 657: Schistosomiasis is transmitted by?
- A. Fish
- B. Snail (Correct Answer)
- C. Cattle
- D. Cyclops
Explanation: ***Snail*** - **Snails** act as the **intermediate host** for all species of Schistosoma, where the parasite undergoes asexual reproduction. - Humans become infected when they come into contact with water contaminated with **cercariae**, which are released from infected snails. *Cyclops* - **Cyclops** (a type of freshwater crustacean) are the intermediate hosts for parasites like **Dracunculus medinensis** (guinea worm) and **Diphyllobothrium latum** (fish tapeworm). - They are not involved in the life cycle or transmission of Schistosoma. *Fish* - Various fish can be intermediate hosts for parasites such as **Clonorchis sinensis** (Chinese liver fluke) or **Diphyllobothrium latum**. - Fish do not play a role in the transmission of schistosomiasis. *Cattle* - **Cattle** can serve as definitive hosts for certain parasites, such as **Taenia saginata** (beef tapeworm), where the larval stage (cysticerci) is found in their muscle tissue. - They are not involved in the life cycle or transmission of Schistosoma.
Question 658: Schistosomiasis is an example of which type of zoonosis that requires an intermediate host?
- A. Meta-zoonoses (Correct Answer)
- B. Cyclo-zoonoses
- C. Direct-zoonoses
- D. Sporo-zoonoses
Explanation: ***Meta-zoonoses*** - **Meta-zoonoses** are defined as zoonotic diseases that require an **intermediate invertebrate host** for the completion of the parasite's life cycle. - **Schistosomiasis** fits this definition as it involves fresh water snails acting as an intermediate host, where the parasite undergoes essential developmental stages. *Cyclo-zoonoses* - **Cyclo-zoonoses** require **more than one vertebrate host species** but no invertebrate host for the completion of the infectious agent's life cycle. - An example would be **Taeniasis**, which involves humans and cattle or pigs, but not an invertebrate. *Direct-zoonoses* - **Direct-zoonoses** are transmitted directly from an **infected vertebrate host to a susceptible vertebrate host** without the need for an intermediate host or vector. - Examples include **rabies** or **brucellosis**, which are passed directly from animals to humans. *Sporo-zoonoses* - **Sporo-zoonoses** are zoonoses where the infectious agent undergoes **sporogonic development in an invertebrate host**, but this term is not a standard or widely recognized category in the same way as direct, cyclo-, or meta-zoonoses. - The more appropriate term for diseases involving an invertebrate intermediate host is **meta-zoonoses**.
Question 659: Which of the following diseases does not have a chronic carrier state?
- A. Malaria
- B. Tetanus (Correct Answer)
- C. Measles
- D. Poliomyelitis
Explanation: ***Tetanus*** - Tetanus is caused by the toxin produced by *Clostridium tetani*, which is an **environmental bacterium** found in soil and does not establish a persistent infection within humans. - Humans are merely **accidental hosts** for this bacterium, meaning there is **no chronic carrier state** where an infected individual continuously harbors and transmits the pathogen. - The disease occurs through wound contamination with spores, not human-to-human transmission. *Measles* - Measles is an **acute viral infection** with no chronic carrier state in the classical sense. - After acute infection, the virus is cleared from the body in immunocompetent individuals. - While **subacute sclerosing panencephalitis (SSPE)** represents a rare persistent infection, this is **not a carrier state** as the virus is not transmissible from these individuals. - SSPE occurs years after initial infection but does not involve viral shedding or transmission. *Malaria* - Individuals infected with ***Plasmodium* parasites** can develop a **chronic carrier state**, particularly with *P. vivax* and *P. ovale*, which form hypnozoites in the liver. - These parasites can remain dormant and then reactivate, causing **relapses** and allowing for continued transmission to mosquitoes over extended periods. - Chronic asymptomatic carriers can serve as reservoirs for transmission in endemic areas. *Poliomyelitis* - Individuals infected with poliovirus can shed the virus in their stools for **several weeks to months** after infection. - In **immunodeficient individuals**, prolonged excretion can occur for years, creating chronic carriers. - This prolonged shedding allows for the **continued transmission** of the virus within a population.
Question 660: Vector of scrub typhus in man?
- A. O. tsutsugamushi
- B. Leptotrombidium deliense (Correct Answer)
- C. Lice
- D. Pediculus humanus
Explanation: ***Leptotrombidium deliense*** - This is the **chigger mite** species primarily responsible for transmitting **scrub typhus** to humans. - **Larval mites (chiggers)** of this species feed on human skin and transmit the bacterium *Orientia tsutsugamushi*. *O. tsutsugamushi* - This is the **causative agent** of scrub typhus, not the vector. - It is a **rickettsial bacterium** transmitted by infected chiggers. *Lice* - **Lice** (e.g., *Pediculus humanus corporis*) are vectors for diseases like **epidemic typhus** (caused by *Rickettsia prowazekii*) and **relapsing fever**, but not scrub typhus. - They are **blood-sucking insects** distinct from mites. *Pediculus humanus* - This refers to **human lice**, specifically *Pediculus humanus capitis* (head louse) or *Pediculus humanus corporis* (body louse). - As mentioned, lice transmit diseases like epidemic typhus, not **scrub typhus**.
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